European journal of medical research
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The adequate management of brain dead donors on an Intensive Care Unit (ICU) is one of the major key points for a successful transplantation of harvested organs. In addition to an invasive monitoring like in any other ICU patient these patients needs a meticulous attention to their hemodynamic. The early administration of desmopressin to treat diabetes insipidus, a differentiated use of fluid resuscitation and a distinct catecholamine support are special features of an appropriate basic treatment. The administration of corticoids has to be considered if a sufficient circulation can not be regained.
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In six awake healthy adults we studied the physiological effects of mechanical unloading of the respiratory muscles during increased ventilatory demand. We were interested in whether respiratory muscle activity is down regulated and if this is mainly a consequence of chemical factors, i.e. CO2-reduction, or non-chemical neuromuscular inhibition. ⋯ Respiratory muscle activity was measured by transdiaphragmatic pressure. Unloading caused a 57 percent reduction of the inspiratory transdiaphragmatic pressure-time product (p<0.05), while tidal volume, breathing frequency, and breathing pattern did not significantly change. These observations suggest that during increased ventilatory requirements, PAV results in down regulation of respiratory muscle activity and that this effect is mainly a consequence of neuromechanical inhibition.
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The results from studies on potential treatment effects of acupuncture are often limited due to serious difficulties in methodology. Randomized controlled trials on acupuncture should test a widely accepted treatment strategy of verum and sham acupuncture. However, in clinical practice various patterns of acupuncture techniques are employed, and up to now no generally accepted guidelines on how to perform a reliable verum or sham treatment have been established. ⋯ For this we used a combination of a comprehensive study of the literature and structured interviews with experienced physicians followed by an expert panel. A total of 41 physicians had to be trained to achieve a homogeneously high quality of acupuncture treatment. The latter represents a prerequisite for reproducibility, constituting a critical component of rigorous efficacy trials in scientific acupuncture research.
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Comparative Study
Demonstration of antibodies to the chitin-binding mistletoe lectin (cbML) in tumor patients before and during therapy with an aqueous mistletoe extract.
Mistletoe extracts exert immunomodulatory properties in vivo and in vitro, and these effects have been related mainly to mistletoe lectin 1 (ML-1). Recently, a new chitin-binding mistletoe lectin (cbML) has been isolated and structurally characterized in these extracts. Aim of the present study was, therefore, to evaluate whether this cbML also affects immunocompetent cells and can for instance activate B-cells to produce anti-cbML-specific antibodies. ⋯ In contrast, anti-ML-1 or -3-antibodies developed in almost 100% of the 25 patients being negative before therapy. These data indicate that cbML can induce immunological responses in patients treated with mistletoe extracts, although it seems to have lower antigenicity. Interestingly, anti-cbML antibodies can be observed in a low incidence also in individuals, not having yet received mistletoe therapy.
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There are about 200,000 hernia repairs per year in Germany and about 770,000 in the U. S. In the United States most hernia repairs (80-90%) are performed as day surgery procedure; 90% of operations are open herniorrhaphies with mesh. ⋯ The new light-weight mesh Ultrapro contributes to the improvement of hernia repair. There is evidence that ambulatory open mesh repair should be the method of choice for primary inguinal hernia. If in Germany an equal proportion of hernia repair as in the United States would be done as ambulatory procedure (80-90%), there would be an annual cost saving of several hundred million Euro.