Med Klin
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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.
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Reduction in organ function is a common problem in the perioperative period of the elderly patient. Especially renal function is often decreased in this situation. ⋯ In elderly patients undergoing major abdominal surgery, short-term alternations in the renal system were observed in the perioperative period. With adequate volume replacement, no relevant disturbances in renal function are to be expected in the elderly surgical patient.
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At present, long-term results after conservative treatment of morbid obesity (body mass index > 40) are not satisfying, given a relapse rate > 95%. In comparison, surgical treatment is about 10 times more efficient and, thus, more cost-effective. ⋯ During a 30-month period, we implanted the adjustable gastric band in 71 patients (65 female and six male patients). All procedures were performed laparoscopically. In none of the cases did intraoperative complications occur. Postoperatively 1.4% of the patients developed a slippage of the gastric band, 2.1% had complications concerning the subcutaneously placed port, and, eventually, the gastric band had to be removed in 1.4%.
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Biochemical markers have been an integrative part of non-invasive diagnostic strategies in cardiology for nearly 50 years, experiencing a renascence by the recently acknowledged prognostic potential of cardiac troponins in acute coronary syndromes. ⋯ Biochemical cardiac markers are a useful tool in the diagnosis of both ischemic and non-ischemic myocardial injury. Among these, cardiac troponins seem to become the gold markers for the new millennium.