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Wyszukujesz frazę "Weiss, Guenter" wg kryterium: Autor


Wyświetlanie 1-5 z 5
Tytuł:
Neurogenic pulmonary edema induced by subarachnoid hemorrhage; case report on diagnostic and therapeutic implications
Autorzy:
Weiss, Guenter
Meyer, Frank
Tematy:
neurogenic pulmonary edema
subarachnoidal hemorrhage
catecholamine
Pokaż więcej
Wydawca:
Index Copernicus International
Powiązania:
https://bibliotekanauki.pl/articles/1395592.pdf  Link otwiera się w nowym oknie
Opis:
An exemplary rare case of neurogenic pulmonary edema induced by intracranial hemorrhage was reported including diagnostic and therapeutic implications as well as management recommendations. A 35-year old man who was treated first by a neurosurgical approach because of a subarachnoid hemorrhage (bore hole trepanation) and subsequently on a surgical intensive care unit because of severe postoperative hemodynamic, cardiocirculatory, and pulmonary disruptions. To monitor cardiopulmonary condition and treatment effects, a Swan-Ganz catheter was placed in the pulmonary artery, since after trepanation, a critical cardiopulmonary status developed during postoperative mechanical ventilation and catecholamine administration. This condition was indicated by neurogenic pulmonary edema detected by control chest X-ray film and high oxygen load in the inspiratory air required for sufficient arterial oxygenation. After use of high positive end-exspiratory pressure (PEEP) (initially directed against neurogenic lesion), adaptation of initial dobutamine doses, initiation of norepinephrine administration, and substitution of fluids, the patient's blood pressure finally rose sufficiently to sustain regular cerebral blood perfusion and achieve better arterial oxygenation. Thus, the patient‘s cardiopulmonary condition stabilized and temporary cardiac insufficiency could be overcome. Subsequently, it became possible to decrease PEEP according to requirements to prevent or limit cerebral edema and to diminish catecholamine doses.
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Successful Management of Non-Occlusive Mesenteric Ischemia (Nomi) - Case Report
Autorzy:
Weiss, Guenter
Lippert, Hans
Meyer, Frank
Tematy:
non-occlusive mesenteric ischemia
mesentericography
intraarterial perfusion catheter
vasodilating treatment
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Wydawca:
Index Copernicus International
Powiązania:
https://bibliotekanauki.pl/articles/1396718.pdf  Link otwiera się w nowym oknie
Opis:
Patients with non-occlusive mesenteric ischemia (NOMI) are still confronted with high mortality. The diagnostic is challenging and difficult because of the unspecific symptomatology. The aim of this systematic scientific report on an extraordinary and uncommon single clinical case and its successful course was to demonstrate the great potential of a partially novel non-surgical approach including its periinterventional management.A 73-year old female is precisely described, who developed an acute abdomen during the postoperative course after cardiosurgical intervention. Only explorative laparotomy clarified the correct diagnosis - NOMI. Despite general intensive care, patient developed multi-organ failure after this second intervention. Using consequently an image-guided minimally invasive radiological approach comprising the introduction of a catheter into the superior mesenteric artery (Seldinger's technique) and the continuous application of vasodilating medication such as alprostadil (prostaglandin) through this catheter enabled us to improve mesenteric perfusion effectively and to overcome multiorgan failure.In conclusion, specific risk factors may help to focus on the suspicion of NOMI. Diagnostic of choice is the arterial mesentericography, which allows specifically to exclude vascular occlusion including the consequence of a prompt surgical approach. Simultaneously, using the setting of the mesenteric angiography catheter can be placed for initiation of regional vasodilating treatment in case of NOMI. Only this approach may avoid fatal outcome.
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Successful Endoscopic Treatment of a Postoperative Tracheomediastinal Fistula Caused by Anastomotic Insufficiency after Esophageal Resection with Fibrin Glue
Autorzy:
Weiss, Guenter
Wex, Cora
Lippert, Hans
Schreiber, Jens
Meyer, Frank
Tematy:
tracheomediastinal fistula
esophageal resection
fibrin glue
endoscopic approach
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Wydawca:
Index Copernicus International
Powiązania:
https://bibliotekanauki.pl/articles/1395989.pdf  Link otwiera się w nowym oknie
Opis:
Fistula development after esophageal resection is considered as one of the most serious postoperative complications. The authors reported a case on clinical experiences in the postoperative diagnostic and successful therapeutic management of a tracheomediastinal fistula after esophageal resection, using endoscopic application of fibrin glue. The early approach of an anastomotic insufficiency after esophageal resection because of a squamous cell carcinoma (pT3pN0M0G2) below the tracheal bifurcation including transposition of a re-modelled gastric tube and end-to-side anastomosis 24 hours postoperatively in a 55-year old patient combined i) surgical re-intervention from the periesophageal site (reanastomosis, gastroplication, lavage, local and mediastinal drainage) and, later on, ii) extensive rinsing with consecutive endoscopic fibrin glue application into the tracheal mouth of the subsequently developed tracheomediastinal fistula as a consequence of the inflammatory changes within the surrounding tissue. In conclusion, this approach was successful and beneficial for the patient's further postoperative course, which was associated with other complications such as pneumonia and acute myocardial infarction. The fistula closed sufficiently and permanently with no further surgical intervention at the tracheal as well as mediastinal site and allowed patient's later discharge with no further complaints or problems.
Dostawca treści:
Biblioteka Nauki
Artykuł
Tytuł:
Predictive performance and clinical application of COV50, a urinary proteomic biomarker in early COVID-19 infection : a prospective multicentre cohort study
Autorzy:
Rupprecht, Harald D.
Peters, Bjorn
Rajzer, Marek
Feldt, Torsten
Catanese, Lorenzo
Papkalla, Armin
Weiss, Guenter
Siwy, Justyna
Schmiedel, Stefan
Thijs, Lutgarde
Canevska-Taneska, Aleksandra
Banasik, Mirosław
Salgueira Lazo, Mercedes
Metzger, Jochen
Neuhaus, Barbara
Spasovski, Goce
Nilsson, Asa
Lubbert, Christoph
von der Leyen, Heiko
Beige, Joachim
Krajewska, Magdalena
Seilmaier, Michael
Staessen, Jan A.
Stegemann, Miriam
Milenkova, Mimoza
Psichogiou, Mina
Mebazaa, Alexandre
Zoufaly, Alexander
Raad, Julia
Wendt, Ralph
Dzitkowska-Zabielska, Magdalena
Mischak, Harald
Fuławka, Łukasz
Yu, Yu-Ling
Normark, Johan
Czerwieńska, Beata
Kalbitz, Sven
Rothfuss, Katja
Dudoignon, Emmanuel
Rumpf, Benedikt
Opis:
Background: The SARS-CoV-2 pandemic is a worldwide challenge. The CRIT-CoV-U pilot study generated a urinary proteomic biomarker consisting of 50 peptides (COV50), which predicted death and disease progression from SARS-CoV-2. After the interim analysis presented for the German Government, here, we aimed to analyse the full dataset to consolidate the findings and propose potential clinical applications of this biomarker. Methods: CRIT-CoV-U was a prospective multicentre cohort study. In eight European countries (Austria, France, Germany, Greece, North Macedonia, Poland, Spain, and Sweden), 1012 adults with PCR-confirmed COVID-19 were followed up for death and progression along the 8-point WHO scale. Capillary electrophoresis coupled with mass spectrometry was used for urinary proteomic profiling. Statistical methods included logistic regression and receiver operating characteristic curve analysis with a comparison of the area under curve (AUC) between nested models. Hospitalisation costs were derived from the care facility corresponding with the Markov chain probability of reaching WHO scores ranging from 3 to 8 and flat-rate hospitalisation costs adjusted for the gross per capita domestic product of each country. Findings: From June 30 to Nov 19, 2020, 228 participants were recruited, and from April 30, 2020, to April 14, 2021, 784 participants were recruited, resulting in a total of 1012 participants. The entry WHO scores were 1–3 in 445 (44%) participants, 4–5 in 529 (52%) participants, and 6 in 38 (4%) participants; and of all participants, 119 died and 271 had disease progression. The odds ratio (OR) associated with COV50 in all 1012 participants for death was 2·44 (95% CI 2·05–2·92) unadjusted and 1·67 (1·34–2·07) when adjusted for sex, age, BMI, comorbidities, and baseline WHO score; and for disease progression, the OR was 1·79 (1·60–2·01) when unadjusted and 1·63 (1·41–1·91) when adjusted (p<0·0001 for all). The predictive accuracy of the optimised COV50 thresholds was 74·4% (71·6–77·1%) for mortality (threshold 0·47) and 67·4% (64·4–70·3%) for disease progression (threshold 0·04). When adjusted for covariables and the baseline WHO score, these thresholds improved AUCs from 0·835 to 0·853 (p=0·033) for death and from 0·697 to 0·730 (p=0·0008) for progression. Of 196 participants who received ambulatory care, 194 (99%) did not reach the 0·04 threshold. The cost reductions associated with 1 day less hospitalisation per 1000 participants were million Euro (M€) 0·887 (5–95% percentile interval 0·730–1·039) in participants at a low risk (COV50 <0·04) and M€2·098 (1·839-2·365) in participants at a high risk (COV50 ≥0·04). Interpretation: The urinary proteomic COV50 marker might be predictive of adverse COVID-19 outcomes. Even in people with mild-to-moderate PCR-confirmed infections (WHO scores 1–4), the 0·04 COV50 threshold justifies earlier drug treatment, thereby potentially reducing the number of days in hospital and associated costs.
Dostawca treści:
Repozytorium Uniwersytetu Jagiellońskiego
Artykuł
    Wyświetlanie 1-5 z 5

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