Zeitschrift fur die gesamte innere Medizin und ihre Grenzgebiete最新文献_第5页

[Aerosol generation and delivery systems for pulmonary drug administration: theory and practice]. [用于肺部给药的气溶胶产生和输送系统:理论与实践]。

Zeitschrift fur die gesamte innere Medizin und ihre Grenzgebiete Pub Date : 1993-08-01

M T Newhouse

{"title":"[Aerosol generation and delivery systems for pulmonary drug administration: theory and practice].","authors":"M T Newhouse","doi":"","DOIUrl":"","url":null,"abstract":"In recent years aerosol therapy has become increasingly important for the management of asthma and COPD as well as for the treatment of airway and parenchymal infections in bronchiectasis and in AIDS patients with pneumocystis carinii pneumonia. In the management of asthma inhaled steroids have become the mainstay of therapy in adults and children while bronchodilators have been relegated to a secondary role. While there has long been considerable controversy about the best way to generate and deliver aerosols, it has become evident that metered dose inhalers (MDI) and their increasingly sophisticated valved accessory devices are the most efficient, versatile and cost effective aerosol systems for the majority of patients in the adult and paediatric age group. By contrast, nebulizers are inefficient and costly and powder inhalers, while providing aerosol on inhalation, have major limitations in the paediatric age group, in less cooperative or handicapped patients and in those in emergency departments or on assisted ventilation. Recent studies have demonstrated that even in life-threatening asthma, MDI generated aerosols delivered by means of valved holding chambers are better suited to managing the acute episode because of the improved speed of administration and lower cost. Developments in aerosol therapy are likely to remain in the forefront of the management of a variety of airway and pulmonary parenchymal diseases as new and improved pharmaceutical agents and aerosol delivery systems are developed.","PeriodicalId":23901,"journal":{"name":"Zeitschrift fur die gesamte innere Medizin und ihre Grenzgebiete","volume":"48 8","pages":"363-8"},"PeriodicalIF":0.0,"publicationDate":"1993-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19364153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Tuberculosis--a forgotten disease?]. [结核病——被遗忘的疾病?]

Zeitschrift fur die gesamte innere Medizin und ihre Grenzgebiete Pub Date : 1993-08-01

O Wieser

引用次数: 0

[The basic regulation of personal medical care]. 【个人医疗基本规范】。

Zeitschrift fur die gesamte innere Medizin und ihre Grenzgebiete Pub Date : 1993-08-01

M Broglie

引用次数: 0

[77-year-old otherwise healthy colleague, suffers from eosinophilic fasciitis (Shulmann syndrome)]. [77岁的健康同事，患有嗜酸性筋膜炎(舒尔曼综合征)]。

Zeitschrift fur die gesamte innere Medizin und ihre Grenzgebiete Pub Date : 1993-08-01

W Keitel

引用次数: 0

[Obliterating diabetic microangiopathy of the diabetic foot--reality or false conclusion?]. [消除糖尿病足的糖尿病微血管病变——真实还是错误的结论?]。

Zeitschrift fur die gesamte innere Medizin und ihre Grenzgebiete Pub Date : 1993-08-01

E Chantelau

引用次数: 0

[Value of thrombolytic therapy in deep venous thrombosis]. 【溶栓治疗在深静脉血栓中的价值】。

Zeitschrift fur die gesamte innere Medizin und ihre Grenzgebiete Pub Date : 1993-06-01

T Wagner

{"title":"[Value of thrombolytic therapy in deep venous thrombosis].","authors":"T Wagner","doi":"","DOIUrl":"","url":null,"abstract":"Thrombolytic therapy in a large number of patients may prevent post-thrombotic symptoms occurring as late consequences of deep vein thrombosis. In clinical studies, streptokinase either in conventional low dose, longterm, intravenous or in repeated intravenous short term ultra high dose regimens, urokinase and recombinant tissue-type plasminogen activators: all these plasminogen activators have been confirmed to successfully restore the patency of veins. As deep vein thrombosis generally extends over longer distances and are mostly older before being diagnosed, a lysing period of a couple of days must be taken into account. On the other hand, deep vein thromboses aged more than 2 weeks generally are no longer amenable to thrombolytic treatment. Due to their lack of short-term and long-term hazards, thromboses of the arms and the lower legs are not regarded an ideal indication for thrombolysis. Up to now, none of the currently available plasminogen activators has demonstrated superiority over the others, neither in respect of efficacy nor safety. With streptokinase intermittent intravenous ultra-high doses success rates of up to 80% (complete plus partial recanalization) can be achieved within a three-day treatment period. For its accompanying increased hazard of fatal pulmonary embolism, however, it is considered to be contraindicated in patients with pelvine thrombosis. Furthermore, contraindications to streptokinase such as streptococcal infections and prior lysis with streptokinase should always be kept in mind. In these cases streptokinase may be substituted by rt-PA, which, however, in the indication of deep vein thrombosis, is still not well documented today.(ABSTRACT TRUNCATED AT 250 WORDS)","PeriodicalId":23901,"journal":{"name":"Zeitschrift fur die gesamte innere Medizin und ihre Grenzgebiete","volume":"48 6-7","pages":"324-31"},"PeriodicalIF":0.0,"publicationDate":"1993-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19320538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Coronary reocclusion--an unsolved problem in thrombolytic therapy of acute myocardial infarct]. 【冠状动脉再闭塞——急性心肌梗死溶栓治疗中尚未解决的问题】。

Zeitschrift fur die gesamte innere Medizin und ihre Grenzgebiete Pub Date : 1993-06-01

K Huber

{"title":"[Coronary reocclusion--an unsolved problem in thrombolytic therapy of acute myocardial infarct].","authors":"K Huber","doi":"","DOIUrl":"","url":null,"abstract":"The main problem after originally successful thrombolytic reperfusion is early thrombotic reocclusion which occurs in up to 20% despite adequate anticoagulant therapy. Early rethrombosis can be attributed to a permanent procoagulatory state caused by residual stenosis, residual thrombosis, by a \"paradoxical\" procoagulatory effect of the thrombolytic agents used, and by the existence of systemic thrombogenic risk factors. Thereby, most important mechanisms of rethrombosis are generation, exposition and activation of thrombin and a thrombin-induced increase in platelet aggregability. Up to now, therapeutic measures have not proved useful (early balloon angioplasty, prolonged t-PA infusion), have not been effective enough (platelet inhibition with aspirin, anticoagulation with heparin), or are not entirely investigated (combination therapy of fibrin-specific with non-specific thrombolytic agents, use of t-PA mutants with prolonged biological efficacy). As far as thrombin plays the key role in the process of rethrombosis, it is believed that the use of specific and highly active thrombin inhibitors, e.g. hirudin, might mostly be appropriate in solving the problem of \"reocclusion\".","PeriodicalId":23901,"journal":{"name":"Zeitschrift fur die gesamte innere Medizin und ihre Grenzgebiete","volume":"48 6-7","pages":"316-23"},"PeriodicalIF":0.0,"publicationDate":"1993-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19320539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Thrombolysis -- past, present, and future]. 【溶栓——过去、现在和将来】。

Zeitschrift fur die gesamte innere Medizin und ihre Grenzgebiete Pub Date : 1993-06-01

引用次数: 0

[Possibilities and limits of local intra-arterial fibrinolysis in thromboembolic vascular occlusions of the central nervous system]. [中枢神经系统血栓栓塞性血管闭塞局部动脉内纤溶的可能性和局限性]。

Zeitschrift fur die gesamte innere Medizin und ihre Grenzgebiete Pub Date : 1993-06-01

F Brassel

{"title":"[Possibilities and limits of local intra-arterial fibrinolysis in thromboembolic vascular occlusions of the central nervous system].","authors":"F Brassel","doi":"","DOIUrl":"","url":null,"abstract":"It is now possible with the help of microcatheters to superselectivity catheterize the cerebral vessels right up to the point of thromboembolic vascular occlusion. Short acting fibrinolytic agents such as urokinase and rt-PA are ideally suited for local intraarterial fibrinolysis (LIF) of thromboembolism in cerebral arteries. Despite high dosages (1,000,000-2,000,000 I.U. urokinase/hr), the risk of symptomatic haemorrhage is relatively low if therapy is started within 4-5 hours of the onset of symptoms and is administered only for a short time (1-2 hrs). To reduce the high mortality rate in patients with thromboembolic occlusion in the vertebrobasilar territory, LIF is the treatment of choice. If therapy is promptly started within 4-5 hours of the clinical onset of symptoms, a favourable clinical course may result even in patients with internal carotid artery or middle cerebral artery occlusions. However, further studies are required to optimize the treatment strategy in the latter group of patients. Results of studies to date have shown that the immediate intraarterial fibrinolysis of the acutely occluded central retinal artery is by far superior to conservative therapy.","PeriodicalId":23901,"journal":{"name":"Zeitschrift fur die gesamte innere Medizin und ihre Grenzgebiete","volume":"48 6-7","pages":"351-5"},"PeriodicalIF":0.0,"publicationDate":"1993-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19320542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Value of thrombolytic therapy in childhood]. [儿童溶栓治疗的价值]。

Zeitschrift fur die gesamte innere Medizin und ihre Grenzgebiete Pub Date : 1993-06-01

M Wilken

引用次数: 0