Wiener klinische Wochenschrift
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Wien. Klin. Wochenschr. · Jan 1993
[Prospective study of determining the value of D-dimer in diagnosing pulmonary embolism].
Pulmonary embolism (PE) is still misdiagnosed in a high proportion of cases. 107 patients admitted for suspected pulmonary embolism were studied prospectively to shed light on the value of ELISA-D-dimer and Latex-D-dimer. Pulmonary embolism was ruled out by negative perfusion scans in 66 patients (61.7%) and by angiography in 24 patients. 58% of the scans suggesting a high probability of PE were confirmed by angiography, but only 18% of the scans suggesting a low or intermediate probability of PE. ⋯ The positive predictive value was improved by ELISA-D-dimer in both groups to 75%. In order to augment the diagnostic efficacy in clinical practice the determination of Latex-D-dimer simultaneously with lung scanning is recommended.
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Wien. Klin. Wochenschr. · Jan 1993
[Hemorrhagic complications after tonsillectomy and adenoidectomy. Experiences with 7,743 operations in 14 years].
During 14 years the department of otolaryngology at Leoben performed 7743 tonsillectomies and/or adenoidectomies in children in cooperation with the department of pediatrics. 97 patients were treated for postoperative bleeding = 1.25%; one child died as a consequence of severe bleeding. The analysis of age, timing and severity of the bleeding includes 15 additional children whose surgery had been performed elsewhere. Only 7 of the 112 bleeding episodes occurred during the first 24 hours after surgery. ⋯ Because of severe blood loss, 18 patients received a blood transfusion. Despite pre- and postoperative coagulation tests no patient suffering from a coagulation disorder was identified. Neither the coagulation screening nor a 48 to 72 hour postoperative in hospital observation could prevent the risk of postoperative bleeding.
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In the present retrospective study we report on antibacterial chemotherapy in patients suffering from a septic kidney. The results were documented in a course table, in which the septic parameters were divided into scores from 0 to 4 allowing to follow each patient's course with respect to the indicated scores. ⋯ In all cases within 6 days from the onset of this therapy the septic parameters turned to normal values. None of the 24 patients suffering from a severe course of urosepsis, all treated at the University Hospital of Urology in Innsbruck between 1980 and 1990, died.
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Wien. Klin. Wochenschr. · Jan 1993
[Electrosurgical loop excision as diagnostic and simultaneously therapeutic intervention in cervical intraepithelial neoplasia].
109 women referred to our center for colposcopy because of suspicious cervical cytology and in whom an abnormal epithelial pattern was diagnosed on colposcopy, or in whom a discrepancy between cytology and colposcopy was encountered, concomitantly underwent loop electrosurgical excision procedure as an outpatient procedure. All removed specimens were examined and no invasive cancer was found in any of them. No serious complications occurred. Ambulatory loop electrosurgical excision procedure appears to be a cost-effective and well tolerated treatment modality for the management of women with cervical intraepithelial neoplasia, with the advantage that this conservative procedure allows histologic examination of the removed tissue.