Med Klin
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Case Reports
[Ruptured splenic artery aneurysm--a rare cause of recurrent gastrointestinal hemorrhages].
A 51-year-old asthenic patient attended the hospital with syncope, head injury, tarry stool and severe anemia. There was a history of alcohol and nicotine abuse, but no known preceding diseases of the liver or gastrointestinal tract. Except hypotension, examination of the patient did not show any further abnormalities. ⋯ Pseudoaneurysms of the splenic artery are an uncommon cause of gastrointestinal bleeding. The most important factor in detecting a pseudoaneurysm is considering the diagnosis. It is necessary to check for a pseudoaneurysm secondary to pancreatitis with pulsed or color Doppler imaging especially if a pseudocyst was first diagnosed with abdominal ultrasound. Because of the high mortality of a pseudoaneurysm, surgical resection or interventional radiology should be done as early as possible.
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Randomized Controlled Trial Comparative Study Clinical Trial
[A new paracentesis needle for ascites and pleural effusion compared with the venous indwelling catheter. A prospective, randomized study].
Diagnostic or therapeutic paracentesis of ascites or pleural effusions is part of the daily routine on many hospital wards and in outpatient clinics. In Germany, paracentesis is usually performed with angiocaths. However, the therapeutic large volume paracentesis of ascites and paracentesis of pleural effusions with angiocaths is often cumbersome and quite often paracentesis fails, forcing the physician to repuncture. This is mainly due to the fact that angiocaths are not designed for such interventions. ⋯ The paracentesis needle was objectively superior as compared to the angiocath. It might help to avoid additional complications due to repuncture and it will increase the patients' comfort.
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Patients with severe emphysema from pink puffer type (PPT) are symptom-limited due to dyspnea even at low level of activity. In this study we investigated the clinical effect of oral morphine in this group of patients. ⋯ In patients with severe emphysema from pink puffer type a trial with morphine is justified. In particular the beneficial effect on dyspnea in the responder group and the acceptable rate of side effects underline this strategy.