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  • 1
    Electronic Resource
    Electronic Resource
    Diagnostik kardiovaskulärer Erkrankungen mit Hilfe der suprasternalen M-mode Echokardiographie (1985)
    Springer
    Journal of molecular medicine 63 (1985), S. 193-204 
    Details
    ISSN: 1432-1440
    Keywords: Suprasternal M-mode echocardiography ; Cardiovascular diseases
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The suprasternal approach can be used to image the aortic arch, the right pulmonary artery and the left atrium. Dilatation or dissections involving the aortic arch were detected echocardiographically from the suprasternal notch. The echocardiogram of the right pulmonary artery is altered in cases of acute and chronic pulmonary hypertension. Intrapulmonary thrombi in patients with acute pulmonary embolism were visualized with this technique. A volume overloading of the pulmonary circulation due to a congenital left to right shunt, as well as a decreased pulmonary blood flow due to a congenital right to left shunt causes characteristic changes in the wall motion pattern of the right pulmonary artery. Hypoplasia or aplasia of the central pulmonary arteries can be diagnosed as well. Imaging of the left atrium from the suprasternal notch may help to differentiate between supraventricular and ventricular rhythm disturbances. The suprasternal approach is therefore recommended to be used as a routine part of each echocardiographic examination.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01731169
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  • 2
    Electronic Resource
    Electronic Resource
    Intravenous fibrinolytic therapy of acute myocardial infarction: New perspectives from plasminogen activators? (1986)
    Springer
    Journal of molecular medicine 64 (1986), S. 301-306 
    Details
    ISSN: 1432-1440
    Keywords: Myocardial infarction ; Fibrinolysis ; Plasminogen activators
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The early treatment of acute myocardial infarction has changed rapidly in recent years. Given the fact that an occlusive coronary thrombus can be found in most infarct patients within 4 h after clinical symptoms, the idea of instituting medical or mechanical recanalization of the occluded vessel is intriguing. However, invasive measures are time consuming, expensive and not freely available to a great number of patients. Thus, only i.v. fibrinolytic therapy of acute myocardial infarction will gain wider application in the near future. Several concepts have been worked out, one of which uses a high-dosage streptokinase or urokinase regimen. A different therapeutic alternative has been made possible by the development of selective fibrinolytic substances, such as the tissue-type plasminogen activator (t-PA) or the anisoylated plasminogen-streptokinase activator complex (APSAC). Preliminary clinical data have shown that the coronary artery patency rate achieved after i.v. administration of t-PA or APSAC is higher than that after conventional treatment with streptokinase or urokinase. The incidence of severe bleeding complications is low and comparable in these studies. However, until myocardial salvage has been demonstrated with early i.v. fibrinolytic therapy in acute myocardial infarction in a placebo-controlled randomized trial, this therapeutic concept will still be unsettled.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01711946
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  • 3
    Electronic Resource
    Electronic Resource
    Die Beeinflussung der Organperfusion durch Kalziumblocker und Converting-Enzyminhibitor an der herzinsuffizienten, wachen Ratte (1985)
    Springer
    Journal of molecular medicine 63 (1985), S. 262-267 
    Details
    ISSN: 1432-1440
    Keywords: Captopril ; Diltiazem ; Regional blood flow ; Experimental heart failure
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The present study examined the regional vascular effects (radioactive microspheres) of converting-enzyme inhibition (captopril, 1mg/kg) and calcium-antagonism (diltiazem, 1 mg/kg) in a rat model of cardiac failure due to large myocardial infarction (n=18, infarct size 40% of the left ventricle) both at rest and during submaximal tread-mill exercise. Diltiazem increased renal, gastrointestinal, coronary and cutaneous blood flow at rest by 29%, 28%, 26% and 37% (p〈0.05 each) and enhanced skeletal muscle blood flow during exercise by 16% (p〈0.05). Captopril improved primarily renal and coronary blood flow at rest (by 59% and 23%, respectively,p〈0.05) and reduced vascular resistance in the gastrointestinal bed by 25% (p〈0.05) without significant effects in other circulatory beds. We conclude that the regional vascular effects elicited by converting-enzyme inhibition and calcium antagonism differ considerably in this animal model of congestive heart failure and may be clinically important. The favourable regional vascular profile of diltiazem deserves further clinical investigation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01731472
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  • 4
    Electronic Resource
    Electronic Resource
    Kalziumantagonisten bei Herzinsuffizienz? (1986)
    Springer
    Journal of molecular medicine 64 (1986), S. 993-1002 
    Details
    ISSN: 1432-1440
    Keywords: Congestive heart failure ; Calcium antagonists ; Hemodynamics
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Although beneficial acute hemodynamic effects of calcium antagonists in heart failure have been reported, their use in this setting is still controversial because of the negative inotropic effects produced by these agents. The direct actions of calcium antagonists, that is direct depression of myocardial contractility and coronary and peripheral vasodilatation, are modulated by systemic hypotension-induced baroreceptor activation of autonomic reflexes. Thus, at clinically relevant dosages, the baroreceptor-mediated cardiac stimulatory effects may counterbalance or override the direct negative-inotropic effects, as usually observed with nifedipine or diltiazem. By contrast, with verapamil significant depression of contractility may occur. Newer calcium antagonists with higher vasoselectivity such as nisoldipine or felodipine may be particularly interesting in the setting of congestive heart failure because of pronounced arterial vasodilatation and their additional effects on coronary blood flow, LV-regional wall motion and diastolic function and peripheral blood flow distribution with negligible myocardial effects. Due to their marked vasodilatating properties, newer derivatives may be advantageous in the treatment of heart failure due to coronary artery disease and hypertension. Although limited data concerning long-term efficacy are available, preliminary studies suggest long-term benefit in selected patients. It appears that verapamil should not be used for vasodilator therapy of severe heart failure, since deterioration of LV function may occur.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01757206
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  • 5
    Electronic Resource
    Electronic Resource
    Evaluation of long-term oral levodopa therapy in chronic congestive heart failure (1987)
    Springer
    Journal of molecular medicine 65 (1987), S. 1087-1094 
    Details
    ISSN: 1432-1440
    Keywords: Levodopa ; Inotropic drugs ; Congestive heart failure
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary To evaluate the long-term effects of orally administered levodopa, 11 patients with chronic congestive heart failure (NYHA III–IV) were studied during maintenance therapy (30±1 days) and after withdrawal from levodopa. The daily levodopa dose was 4 g in six patients; because of side effects the levodopa dose was reduced to 2–3 g in the remaining patients. After withdrawal of levodopa, mean pulmonary capillary wedge pressure and mean right atrial pressure increased significantly (from 19±2 to 24±3 and from 7±2 to 9±2 mmHg, respectively). Effective renal plasma flow was 329±57 during levodopa therapy and decreased significantly to 252±27 ml/min after withdrawal of levodopa. The number of ventricular premature contractions and couplets increased during levodopa therapy and decreased again significantly after withdrawal of levodopa. No significant differences between on and off levodopa were observed in resting heart rate, arterial blood pressure, cardiac index, stroke work index, systemic vascular resistance, sodium and water excretion, or creatinine clearance. Seven patients improved on levodopa therapy by one NYHA class; four of these seven patients deteriorated again by one NYHA class after withdrawal of levodopa. Regarding both clinical and hemodynamic changes after withdrawal of levodopa, three patients were classified as responders to long-term levodopa therapy. All three responders received 4 g levodopa per day. Average dopamine plasma level was 5.3±0.8 ng/ml in the responder group and 2.0±0.5 ng/ml in the nonresponder group. Long-term administration of oral levodopa is associated with beneficial clinical and hemodynamic response in only a minority of patients with chronic congestive heart failure.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01736115
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  • 6
    Electronic Resource
    Electronic Resource
    Einfluß einer adjuvanten Immunglobulintherapie auf Infektionen bei Patienten einer operativen Intensiv-Therapie-Station (1986)
    Springer
    Journal of molecular medicine 64 (1986), S. 245-256 
    Details
    ISSN: 1432-1440
    Keywords: Immunoglobulin therapy ; Severe infections ; Intensive care patients
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A randomized controlled clinical trial was conducted on the effects of immunoglobulin in therapy for infections in 104 intensive care patients. At the first sign of infection, one group of 50 patients received an i.v. preparation of immunoglobulin (4×100 ml) combined with antibiotics. The other 54 control patients received antibiotics alone. The most common infections in these patients were pneumonia, septicemia, peritonitis and wound sepsis. Infections were significantly seldom the cause of death, especially in patients with high-risk surgery who had been treated with immunoglobulin (p≤0.05). Likewise ventilation time in the high-risk surgery group averaged only 5.5 days for those receiving immunoglobulin as opposed to 12.7 days in controls (p≤0.01). Whereas the control group, in particular patients with pneumonia, remained in intensive care an average of 21.5 days, those receiving immunoglobulin stayed only 14.8 days (p≤0.01). In general, patients treated with immunoglobulin recovered more rapidly from infections than did controls (p≤0.01).
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01711930
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  • 7
    Electronic Resource
    Electronic Resource
    Pharmacokinetics of carteolol in relation to renal function (1985)
    Springer
    European journal of clinical pharmacology 29 (1985), S. 461-465 
    Details
    ISSN: 1432-1041
    Keywords: carteolol ; chronic renal failure ; pharmacokinetics ; dosage adjustment ; metabolism
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary The plasma levels and urinary excretion of carteolol and its main metabolites 8-hydroxycarteolol and carteolol glucuronide were investigated in 6 healthy subjects and 9 patients with varying degrees of renal impairment following a single oral dose of 30 mg carteolol hydrochloride. In healthy subjects the half-life of carteolol was 7.1 h. 63% of the administered dose was recovered unchanged in urine, and in all 84% was excreted by the kidneys. The renal clearance of carteolol was 255 ml/min. In chronic renal failure (CRF) the terminal half-life was increased to a maximum of 41 h. Both the elimination rate constant and renal clearance were closely related to the creatinine clearance. In CRF the recovery of carteolol and its metabolites from urine was considerably reduced, suggesting that another pathway of drug elimination becomes relevant in renal disease. To avoid an increase in side-effects due to drug accumulation, the dosage of carteolol should be adjusted in relation to the reduction in creatinine clearance. The maintenance dose should be reduced to a half in patients with a creatinine clearance below 40 ml/min and above 10 ml/min. In those with a creatinine clearance of 10 ml/min or less, the dose should be reduced to 1/4.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00613462
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  • 8
    Electronic Resource
    Electronic Resource
    Influence of architectural design on nosocomial infections in intensive care units—a prospective 2-year analysis (1989)
    Springer
    Intensive care medicine 15 (1989), S. 179-183 
    Details
    ISSN: 1432-1238
    Keywords: Intensive care units ; Nosocomial infections ; Architectural design
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Nosocomial infection rates in an old intensive care ward constructed in 1924 were compared with those in a new one constructed in 1986. The nosocomial infection rate in the old unit was 34.2% and that in the new unit 31.9%, with an average of 33%. The most frequent infections were: pneumonia, urinary tract infection, septicaemia and wound infection. After transfer of the intensive care unit (ICU) the incidence and profile of nosocomial infections remained the same. These findings suggest that the influence of architectural design has little impact on the incidence of nosocomial infections.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01058570
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  • 9
    Electronic Resource
    Electronic Resource
    In vitro activity of five quinoline derivatives against nosocomial isolates ofStaphylococcus andPseudomonas species (1985)
    Springer
    European journal of clinical microbiology & infectious diseases 4 (1985), S. 72-73 
    Details
    ISSN: 1435-4373
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02148670
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    Paper (German National Licenses)
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  • 10
    Electronic Resource
    Electronic Resource
    Systemic and regional vascular effects of atrial natriuretic peptide in a rat model of chronic heart failure (1987)
    Springer
    Basic research in cardiology 82 (1987), S. 517-529 
    Details
    ISSN: 1435-1803
    Keywords: atrial natriuretic peptide ; heart failure ; regionalblood flow
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary To characterize the systemic and regional vascular effects of atrial natriuretic peptide (ANP) in chronic heart failure, central hemodynamics, regional blood flow and plasma ANP levels were determined in a rat model of myocardial infarction and failure and in sham-operated animals. Measurements were made in the conscious state before and after intravenous rANP [99-126] (8 μg bolus followed by continuous infusion of 1.0 μg/kg/min). With this protocol, ANP significantly decreased cardiac output, right atrial, left ventricular enddiastolic and arterial pressures and there were increases in heart rate, systemic and intestinal vascular resistances in sham animals. Renal blood flow per gram of tissue was unchanged with ANP, but when expressed as a percentage of cardiac output, increased significantly, indicating a preferential renal vasodilatory effect of ANP. In rats with infarction and failure, this dose did not alter cardiac output or arterial pressure, but decreased right atrial and left ventricular blood flow. Although significantly reduced as compared to the control group, renal blood flow was not improved with ANP in the heart failure group. ANP plasma levels of the heart failure group were elevated at baseline (p〈0.01), and increased 5–10 times after infusion of rANP. Thus, in rats with chronic heart failure, the renal vascular effects of ANP are blunted, which may, in part, explain the failure of ANP to restore the altered volume homeostasis in heart failure despite elevated ANP plasma levels. However, the effects on venous return were preserved which, in turn, improved cardiac performance via a reduction of preload.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01907221
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