Swiss medical weekly
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The histories of patients with flail chest and respiratory insufficiency caused by blunt chest injury have been analyzed. The first group represented patients with surgical stabilization of 3-4 ribs by introduction of "Rehbein plates" into the medullary cavity (10 patients 1972-1975). The patients of the second group have been supported by controlled mechanical respiration (11 patients 1972-1975). ⋯ Severe bronchial infections caused by hospital germs have occurred more frequently in patients on long-term intubation and mechanical respiration. The average age of patients was almost the same in both groups. The technique of surgical stabilization of the ribs is described, and the advantages and limits of surgical and conservative management of respiratory insufficiency caused by flail chest are discussed.
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Swiss medical weekly · Mar 1978
[Certain and disputed indications of immunosuppressive therapy in kidney diseases].
The effect of immunosuppressive agents in different glomerulopathies is reviewed and some guidelines for their use in clinical practice are proposed. The immunological aspects of pyelonephritis and interstitial nephritis are studied to evaluate future possibilities of either therapeutic immunosuppression or immunization in these diseases.
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Prior to the end of June 1967, a total of 22 kidney allotransplantations had been performed at the Kantonsspital Zurich, Switzerland, with the exclusive use of cadaver kidneys. Ten years later, 10 patients are still alive, 8 of them with functioning primary transplant. In none of these patients is the serum creatinine higher than 1.6 mg%. 6 of the 8 patients are at work full-time and 2 half-time.
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Swiss medical weekly · Nov 1977
[Determination of serum digoxin: a path to better control of therapy?].
The usefulness of serum digoxin measurements in the diagnosis of digitalis toxicity was studied prospectively in hospitalized patients. Serum levels were increased above 2 ng/ml in 28 of 32 cases with digoxin-induced arrhythmias and/or gastrointestinal symptoms, whereas only 1 of 35 non-toxic patients had an abnormal serum concentration. There was, however, no direct relationship between the type of toxic manifestation and absolute values of serum digoxin.
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Swiss medical weekly · Oct 1977
[Antibody-coated bacteria and localization of urinary tract infection].
The distinction between upper and lower urinary tract infection (UTI) is of great help in the management and treatment of these conditions. The antibody-coating technique was used to investigate urine of patients with nephrostomies, chronic and acute pyelonephritis, chronic and acute cystitis, of male patients with dysuria and significant bacteriuria and of female patients with indwelling catheters. Furthermore this indirect method was compared with FAIRLEY'S direct method for localization of UTI in female patients with indwelling catheters. ⋯ The demonstration of antibody-coated bacteria in the urine is a simple and reliable method of localizing the site of a UTI. False positive results may be observed in patients with indwelling catheters and prostatitis; in both instances there is probably local antibody production and coating of the bacteria. As the test is relatively expensive and time-consuming, it is indicated only in special situations and is not considered a routine screening procedure.