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  • 1
    Electronic Resource
    Electronic Resource
    Serum and erythrocyte magnesium in critically ill patients (1996)
    Springer
    Intensive care medicine 22 (1996), S. 724-727 
    Details
    ISSN: 1432-1238
    Keywords: Key words Intracellular magnesium ; Magnesium ; Magnesium deficiency ; Prognosis in intensive care unit
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objectives: To evaluate the prevalence of serum and erythrocyte magnesium (Mg) abnormalities in patients on admission to the intensive care unit (ICU) and to test the hypothesis that low levels of Mg are associated with a higher mortality. Design: Prospective study. Setting: 14-bed ICU in a 1000-bed teaching hospital. Patients: 179 consecutive patients admitted over a 4-month period. Measurements: Total serum Mg (Mgs) and erythrocyte Mg (Mge) were determined on admission by atomic absorption spectrophotometry. Severity of illness was assessed by Acute Physiology and Chronic Health Evaluation (APACHE) II and the number of organ system failures (OSF) during the first 24 h. The patients were followed up until discharge from hospital. Main results: On admission, 79 patients (44%) were hypomagnesemic and 10 (6%) were hypermagnesemic. A low level of Mge was observed in 119 patients (66%). In patients with similar APACHE II scores and OSF numbers, more of those with hyperMgs died during their ICU stay. However, the Mge value on admission did not correlate with patient outcome. Conclusions: We confirm the high prevalence of Mgs abnormalities as well as Mg deficiency on admission to a medical ICU. Low levels of Mgs and Mge are not associated with higher fatality. HyperMgs was associated with patient death.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01709512
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  • 2
    Electronic Resource
    Electronic Resource
    Serum and erythrocyte magnesium in critically ill patients (1996)
    Springer
    Intensive care medicine 22 (1996), S. 724-727 
    Details
    ISSN: 1432-1238
    Keywords: Intracellular magnesium ; Magnesium ; Magnesium deficiency ; Prognosis in intensive care unit
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objectives To evaluate the prevalence of serum and erythrocyte magnesium (Mg) abnormalities in patients on admission to the intensive care unit (ICU) and to test the hypothesis that low levels of Mg are associated with a higher mortality. Design Prospective study. Setting 14-bed ICU in a 1000-bed teaching hospital. Patients 179 consecutive patients admitted over a 4-month period. Measurements Total serum Mg (Mgs) and erythrocyte Mg (Mge) were determined on admission by atomic absorption spectrophotometry. Severity of illness was assessed by Acute Physiology and Chronic Health Evaluation (APACHE) II and the number of organ system failures (OSF) during the first 24 h. The patients were followed up until discharge from hospital. Main results On admission, 79 patients (44%) were hypomagnesemic and 10 (6%) were hypermagnesemic. A low level of Mge was observed in 119 patients (66%). In patients with similar APACHE II scores and OSF numbers, more of those with hyperMgs died during their ICU stay. However, the Mge value on admission did not correlate with patient outcome. Conclusions We confirm the high prevalence of Mgs abnormalities as well as Mg deficiency on admission to a medical ICU. Low levels of Mgs and Mge are not associated with higher fatality. HyperMgs was associated with patient death.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01709512
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Facial mask noninvasive mechanical ventilation reduces the incidence of nosocomial pneumonia (1997)
    Springer
    Intensive care medicine 23 (1997), S. 1024-1032 
    Details
    ISSN: 1432-1238
    Keywords: Key words Epidemiology in ICU ; Facial mask mechanical ventilation ; Logistic Regression Model ; Nosocomial pneumonia ; Ventilator-associated pneumonia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: To evaluate the impact of noninvasive positive pressure mechanical ventilation (NPPV) on ventilator-associated pneumonia (VAP). Design: Prospective observational study. Setting: Medical intensive care unit (ICU) of a university teaching hospital. Patients: Cohort of 320 consecutive patients staying in the ICU more than 2 days and mechanically ventilated for ≥ 1 day. Measurements and results: VAP was diagnosed when, satisfying classical clinical and radiological criteria, fiberoptic bronchoalveolar lavage and/or protected specimen brush grew ≥ 104 and ≥ 103 CFU/ml, respectively, of at least one microorganism. Patients were classified into four subgroups according to the way in which mechanical ventilation was delivered: NPPV then tracheal intubation (TI) (n = 38), TI then NPPV (n = 23), TI only (n = 199), and NPPV only (n = 60). Occurrence of VAP was estimated by incidence rate and density of incidence. Risk factors for VAP were assessed by logistic regression analysis. Twenty-seven patients had 28 episodes of VAP. The incidence rates for patients with VAP were 18 % in NPPV-TI, 22 % in TI-NPPV, 8 % in TI, and 0 % in NPPV (p 〈 0.0001). The density of incidence of VAP was 0.85 per 100 days of TI and 0.16 per 100 days of NPPV (p = 0.04). Logistic regression showed that length of ICU stay and ventilatory support were associated with VAP. Conclusions: There is a significantly lower incidence of VAP associated with NPPV compared to tracheal intubation. This is mainly explained by differences in patient severity and risk exposure.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001340050452
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  • 4
    Electronic Resource
    Electronic Resource
    Effects of prone position on alveolar recruitment and oxygenation in acute lung injury (1999)
    Springer
    Intensive care medicine 25 (1999), S. 1222-1230 
    Details
    ISSN: 1432-1238
    Keywords: Key words Acute respiratory failure ; Alveolar recruitment ; Mechanical ventilation ; Prone position ; Respiratory mechanics
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: To investigate the effects of prone position (PP) on alveolar recruitment and oxygenation in acute respiratory failure.¶Design: Prospective physiologic study.¶Setting: Medical ICU two in a university hospital.¶Patients: Twelve adult patients intubated and mechanically ventilated with medical primary acute lung injury/adult respiratory distress syndrome (ALI/ARDS) in whom PP was indicated.¶Measurements and results: We constructed the static inflation volume-pressure curves (V-P) of the respiratory system in the 12 patients and differentiated between lung and chest wall in ten of them. We determined the difference between end-expiratory lung volume on positive end-expiratory pressure (PEEP) and relaxation volume of the respiratory system on zero PEEP (ΔFRC). The recruited alveolar volume was computed as the ΔFRC times the ratio of static elastance of the respiratory system to the lung. These measurements together with arterial blood gases determination were made in supine position (SP1), after 1 h of PP and after 1 h of supine repositioning (SP2) at the same level of PEEP. The PaO2/FIO2 ratio improved from SP1 to PP (136 ± 17 vs 204 ± 24 mm Hg; p 〈 0.01). An PP-induced alveolar recruitment was found in five patients. The change in oxygenation correlated to the recruited volume. The static elastance of the chest wall decreased from 4.62 ± 0.99 cmH2O/l in SP1 to 6.26 ± 0.54 cmH2O/l in PP (p 〈 0.05) without any correlation to the change in oxygenation.¶Conclusions: Alveolar recruitment may be a mechanism of oxygenation improvement in some patients with acute hypoxemic respiratory failure. No correlation was found between change in oxygenation and chest wall elastic properties.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001340051050
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  • 5
    Electronic Resource
    Electronic Resource
    Vitamin D receptor polymorphisms as markers in prostate cancer (1999)
    Springer
    Human genetics 〈Berlin〉 105 (1999), S. 281-287 
    Details
    ISSN: 1432-1203
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine
    Notes: Abstract. Polymorphisms in the vitamin D receptor (VDR) gene have been analyzed in several studies for an association with prostate cancer (PCA) and odds ratios (OR) ≥3 have been observed in study populations from North America. We studied three polymorphisms in the VDR gene (poly-A microsatellite, TaqI and FokI RFLPs) in 105 controls and 132 sporadic PCA cases from France and in a collection of families from Germany and France. The polymorphisms near the 3' end of the gene were in linkage disequilibrium with an almost complete coincidence of the short poly-A alleles and t (presence of the restriction site) of the TaqI polymorphism, (contingency tables, P〈0.0001). An association was found by logistic regression for the poly-A between PCA and the heterozygous genotype (S/L; S〈17, L≥17, OR=0.44, 95% confidence interval, CI=0.198–0.966, P=0.041). OR was lower in patients ≤70 years old and patients with a Gleason score ≥6. The Tt genotype of the TaqI RFLP also showed an association with PCA (OR=0.5, CI=0.27–0.92, P=0.026). This association was also stronger for patients ≤70 years old (OR=0.31, CI=0.15–0.63, P=0.001). The risk alleles were S and t alleles as indicated by the OR of the homozygotes, although these were not significant. The FokI RFLP at the 5' end of the gene did not reveal any association (P〉0.7). While some association studies differ between Europe and North America, our present findings with the VDR gene agree with those from North America, indicating a weak but general role of the VDR in PCA susceptibility.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004399900119
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  • 6
    Electronic Resource
    Electronic Resource
    Gene amplifications in advanced-stage human prostate cancer (1995)
    Springer
    Urological research 22 (1995), S. 343-347 
    Details
    ISSN: 1434-0879
    Keywords: Prostate carcinoma ; Prostatic neoplasms ; Gene amplifications ; Oncogenes ; Advanced-stage disease
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Gene amplification is a model of proto-oncogene alterations occasionally observed in human tumors. This amplification can, in some cases, have prognostic value (N-myc in neuroblastoma, c-erbB2 and int-2 in breast cancer, etc.). Amplifications of the proto-oncogenes c-myc, c-erbB2 and int-2 have not yet been report in prostate adenocarcinoma, which, like breast cancer, is hormone dependent. We sought amplifications of these three proto-oncogenes by means of Southern blotting in 15 human prostate adenocarcinoma specimens, most of which were advanced (7 stage C and 6 stage D1 or D2). We confirmed the lack of c-myc and c-erbB2 amplification, regardless of the stage, in contrast to the case of breast cancer. Int-2 amplification was observed in one advanced tumor with bone metastases, out of a total of six stage D tumors. The precise frequency of int-2 amplification and its role in prostate carcinogenesis remain to be determined.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00296872
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