Deutsche medizinische Wochenschrift
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The per capita publication output of German medical research is low compared not only to the English-speaking nations but also to Austria and Switzerland. We assessed the publications from German universities in the leading English language general medical journals: New England Journal of Medicine (NEJM), Lancet, Journal of the American Medical Association (JAMA), and British Medical Journal (BMJ). ⋯ Large differences were found between the German universities with respect to publications in the leading English Language general medical journals.
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Dtsch. Med. Wochenschr. · Jan 2001
Randomized Controlled Trial Clinical Trial[Acetyl starch as volume substitute, a possible alternative to HES].
Pharmacokinetics and tolerability of acetyl starch (ACS) in comparison to hydroxyethyl starch (HES) were investigated after repeated intravenous infusions. METHODS AND COHORTS: A 500 ml solution of ACS (n = 8) or HES (n = 9) was infused to male volunteers (Age 25-42 Years) over four hours on five consecutive days. ⋯ According to these data ACS is an alternative to HES for volume replacement. Well-known side effects due to long storage of HES in tissues may not occur following application of ACS. However, the wide usage of ACS is restricted by the limited stability of ACS solutions at room temperature. ACS solutions are thus only stable during storage at lower temperatures.
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Dtsch. Med. Wochenschr. · Jan 2001
[Myocardial infarction and coronary artery ventricular fistulas due to blunt chest trauma]
An 18-year-old previously healthy, cigarette smoking man with no other risk factors for ischaemic heart disease, was admitted to hospital after being kicked in the chest by a horse. On arrival he complained about pain in the lower mediastinum. INVESTIGATIONS: The ECG showed sinus rhythm, right bundle branch block and convex bowed ST elevation in leads V1-V3. Sixty minutes after the incident the cardiac enzymes (creatinekinase-MB fraction, troponin I) were significantly raised. Despite an only slightly reduced left ventricular function documented by transthoracic echocardiography, SPECT-thallium scan showed large scintigraphic defects. Coronary heart disease was excluded by coronary angiography. Four small coronary-ventricular fistulas were identified. Laevocardiography showed a hypokinesia in the antero-septal region. DIAGNOSIS, TREATMENT AND COURSE: We assumed traumatic myocardial infarction of the anterior wall and rupture of multiple small coronary vessels, leading to coronary-ventricular fistulas. No interventional or surgical therapy was performed. Later on the left ventricular function became normal. Echocardiography merely outlined an akinetic scar in the middle of the septum. At exercise ECG test sixteen months later, the patient remained asymptomatic and was able to exercise without any signs of ischaemia up to a work load of 175 W. Furthermore, the fistulas could be seen by echocardiography. ⋯ Cardiac involvement should be considered in all cases of blunt chest trauma. In addition to a traumatic myocardial infarction fistulas may also, though rarely, occur. Myocardial scintigraphy after cardiac contusion is not suitable for diagnosing myocardial ischaemia or vitability.