Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Dec 1991
Case Reports[Atraumatic Clostridium septicum infection in granulocytopenia].
A fatal Clostridium septicum infection occurred in three patients. Case 1. A 55-year-old man died of septicaemia resulting from granulocytopenia of uncertain aetiology; it was associated with perforation of ileal mucosal ulcers. ⋯ Myonecrosis of the left arm, caused by Clostridium septicum, developed without external cause in a 12-year-old girl with congenital neutropenia. Despite aggressive surgical intervention she died of toxic shock. Autopsy revealed caecal mucosal ulcers as the portal of entry of Clostridium septicum.
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Dtsch. Med. Wochenschr. · Nov 1991
Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial[Comparison of the antiemetic effectiveness of granisetron and alizapride plus dexamethasone in cytostatic therapy].
In a randomized single-blind international multicentre trial, two antiemetic regimens were compared in 115 oncology patients undergoing chemotherapy for the first time (cisplatin greater than 15 mg/m2, or ifosfamide greater than 1200 mg/m2 or etoposide greater than 120 mg/m2). One group received granisetron, a 5-hydroxytryptamine type-3-receptor antagonist, 40 micrograms/kg alone intravenously before chemotherapy, with, if necessary, up to two further doses daily of 40 micrograms/kg. The second group received a combination of alizapride plus dexamethasone (4 mg/kg alizapride and 8 mg/kg dexamethasone before chemotherapy, repeated, if necessary, after 4 and 8 hours up to two additional doses). ⋯ The frequency (29% vs 32%) and nature of side effects (obstipation, diarrhoea, headaches, anxiety, vertigo), the causes of which were not differentiated, were similar. No extrapyramidal reactions occurred with granisetron. Of the 62 patients treated with granisetron, 47 did not require any further granisetron after the single daily prophylactic dose.
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Dtsch. Med. Wochenschr. · Oct 1991
Comparative Study[The results of resuscitations in an emergency service].
In a prospective study 166 consecutive cases of prehospital resuscitation by emergency doctors were analysed to ascertain those factors which affect the ultimate outcome. Cardiac causes were most frequent (69%): primary ventricular fibrillation was the most common ECG diagnosis (47%). ⋯ Favourable factors were: primary ventricular fibrillation and start of resuscitation manoeuvres within 10 minutes. These results highlight the need for training first-aid personnel so that the number of successful resuscitations can be increased.