Klinische Wochenschrift
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Klinische Wochenschrift · Dec 1981
Case ReportsDecreased production or increased turnover of antithrombin III in severe acquired coagulopathy?
During the course of severe coagulopathy in an infant suffering from septicaemia and shock, antithrombin III levels were determined repeatedly before and during substitution therapy with human antithrombin. By mathematical analysis of these data, using a biexponential function, the plasma elimination half-life of the antithrombin III was estimated to be 7.5-10.5 h. ⋯ The estimation of the plasma elimination half-life of antithrombin III helps to differentiate decreased production from increased consumption in cases of severe coagulopathy. Thus, a more precise diagnosis of disseminated intravascular coagulation can be made whilst taking advantage of substitution therapy and avoiding the hazards of radioactive tracer proteins.
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Klinische Wochenschrift · Nov 1981
Case Reports[Lactate acidosis from vitamin B1 deficiency (author's transl)].
This is report of a patient receiving preoperatively parenteral nutrition free of vitamin B1. Intraoperatively a severe lactate acidosis developed. This specific metabolic disorder was normalized only by adequate vitamin B1 substitution. Therefore one has to consider vitamin B1 deficiency as another cause of metabolic acidosis.
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Klinische Wochenschrift · Jun 1981
Treatment of acute pulmonary failure by CPAP via face mask: when can intubation be avoided?
Continuous positive airway pressure (CPAP) is used frequently to improve gas exchange in acute pulmonary failure. We investigated clinical and respiratory variables in 98 patients presenting with two or more of the classical criteria for endotracheal intubation and mechanical ventilation. ⋯ Posttraumatic and postoperative pulmonary problems responded better to this therapy than lung dysfunction secondary to left heart failure, sepsis or pneumonia. Abundant expectorations, discoordination of respiratory movements and an increase in arterial carbon dioxide were frequently associated with failure of CPAP by mask and the necessity of endotracheal intubation and mechanical ventilation.
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Clinical findings and course of the disease are described in 6 patients suffering from pulmonary histiocytosis X. Diagnosis was suspected when a reticulo-nodular pattern was detected by conventional X-ray or by computerized tomography of the lungs. ⋯ Signs of the disease improved spontaneously in one patient and when cytostatics were given in two of five patients. To judge the course of the disease, repeated controls of lung function parameters -- besides roentgenographic methods -- were of particular value.
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Klinische Wochenschrift · Apr 1979
ReviewThe involvement of the sympathetic nervous system in tetanus.
Besides the characteristic disturbances of the motor nervous system symptoms indicating an overactivity of the sympathetic nervous system can complicate the course of severe cases of tetanus. These symptoms include fluctuating tachycardia and hypertension, electrocardiographic changes, sweating, constipation with development of paralytic ileus and metabolic disorders. These symptoms are comparable to these developing in patients with phaeochromocytoma. ⋯ For the protection of the organism against the overactivity of the sympathetic nervous system a treatment using the combination of beta-adrenergic receptor blocking agents and adrenergic neuron blocking agents has been introduced. A reduction of the mortality rate was achievable by this treatment. Experimental evidence is accumulating that the tetanus toxin affects not only the motor, but also the sympathetic and sensory neurons.