Your email was sent successfully. Check your inbox.

An error occurred while sending the email. Please try again.

Proceed reservation?

Export
  • 1
    facet.materialart.
    facet.materialart.
    German Medical Science GMS Publishing House; Düsseldorf
    In:  132. Kongress der Deutschen Gesellschaft für Chirurgie; 20150428-20150501; München; DOC15dgch631 /20150424/
    Publication Date: 2015-04-25
    Keywords: ddc: 610
    Language: English
    Type: conferenceObject
    Signatur Availability
    BibTip Others were also interested in ...
  • 2
    ISSN: 1432-2307
    Keywords: Necrotizing fasciitis ; Endocarditis ; Myocarditis ; Epicarditis ; Aspergillus
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A patient with Aspergillus endocarditis, myocarditis and pericarditis is described. A 55-year-old man developed necrotizing fasciitis of the lower abdominal wall, pelvis and right thigh. Despite aggressive surgical débridement and antibiotic coverage, the patient died of multisystem organ failure. Autopsy revealed Aspergillus thromboulcerative endocarditis, myocarditis and pericarditis, acute necrotizing fungal bronchopneumonia and mycotic dissemination to brain, kidney and thyroid gland. A review of the literature showed that in the absence of open-heart surgery Aspergillus endocarditis and myocarditis are very uncommon.
    Type of Medium: Electronic Resource
    Signatur Availability
    BibTip Others were also interested in ...
  • 3
    ISSN: 1432-055X
    Keywords: Schlüsselwörter Trauma ; Stoffwechsel ; totale parenterale Ernährung ; Glukose ; Fruktose ; Fettemulsionen ; Glukose-/Fettsäuren-Zyklus ; Key words Trauma ; Metabolism ; Total parenteral nutrition ; Glucose ; Fructose ; Lipid emulsions ; Glucose-Fatty-Acid-Cycle
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Parenteral nutrition required following surgery or injury should not only meet post-aggression caloric requirements but also match the specific metabolic needs so as not to worsen the metabolic disruptions already present in this situation. The primary objective of parenteral nutrition is body protein maintenance or restoration by reduction of protein catabolism or promotion of protein synthesis or both. Whether all parenteral energy donors, i.e., glucose, fructose, other polyols, and lipid emulsions, are equally capable of achieving this objective continues to be a controversial issue. The objective of the present study was to answer the following questions: (1) Do glucose and fructose differ in their effects on the metabolic changes seen following surgery or injury, the changes in glucose metabolism in particular? (2) Can the observation of poorer glucose utilization in the presence of lipids be confirmed in ICU patients? Patients, materials and methods. A prospective, randomized clinical trial has been conducted in 20 aseptic surgical ICU patients to generate an objective database along these lines by performing a detailed analysis of the metabolic responses to different parenteral nutrition protocols. The effects of a glucose solution+lipid emulsion regimen vs fructose solution+lipid emulsion regimen on a number of carbohydrate and lipid metabolism variables were evaluated for an isocaloric (carbohydrates: 0.25 g/kg body weight/h; lipids: 0.166 g/kg body weight/h) and isonitrogenous (amino acids: 0.0625 g/kg body weight/h) total nutrient supply over a 10-h study period. Results. A significantly smaller rise in blood glucose concentrations (increase from baseline: glucose+lipids P〈0.001 vs fructose+lipids n.s.) suggested that fructose had a small effect, if any at all, on glucose metabolism. Serum insulin activity showed significant differences as a function of carbohydrate regimen, i.e. infusion of fructose instead of glucose produced a less pronounced increase in insulin activity (increase from baseline: glucose+lipids P〈0.001 vs fructose+lipids P〈0.01). Impairment of glucose utilization by concomitant administration of lipids was observed neither in patients who first received glucose nor in those who first received fructose. Conclusions. As demonstrated, parenteral fructose, unlike parenteral glucose, has a significantly less adverse impact than glucose on the glucose balance, which is disrupted initially in the post-aggression state. In addition, the less pronounced increase in insulin activity during fructose infusion than during glucose infusion can be assumed to facilitate mobilization of endogenous lipid stores and lipid oxidation. Earlier workers pointed out that any rise in free fatty acid and ketone body concentrations in the serum produces inhibition of muscular glucose uptake and oxidation, and of glycolysis. These findings were recorded in a rat model and could not be confirmed in our post-aggression state patients receiving lipid doses commensurate with the usual clinical infusion rates. The serious complications that can result from hereditary fructose intolerance are completely avoidable if a careful patient history is taken before the first parenteral use of fructose. If the patient or family members and close friends, are simply asked whether he/she can tolerate fruit and sweet dishes, hereditary fructose intolerance can be ruled out beyond all reasonable doubt. Only in the extremely rare situations in which it is not possible to question either the patient or any significant other, a test dose will have to be administered to exclude fructose intolerance. The benefits of fructose-specific metabolic effects reported in the literature and corroborated by the results of our own study suggest that fructose is an important nutrient that contributes to metabolic stabilization, especially in the post-aggression phase and in septic patients. Hyperglycaemic states are largely prevented, and fewer patients require exogenous insulin, thus avoiding the frequently underestimated risk of hypoglycaemic states.
    Notes: Zusammenfassung Wie kritisch kranke Patienten im Postaggressionsstoffwechsel parenteral ernährt werden sollen ist nach wie vor Gegenstand zahlreicher Diskussionen. Insbesondere wird kontrovers erörtert, ob Glukose allein oder zusammen mit Fruktose bzw. anderen Polyolen unter Berücksichtigung der traumabedingten Veränderungen im Glukosestoffwechsel als Kalorienträger appliziert werden soll und ob Fett als Bestandteil jedes parenteralen Ernährungsprogramms verabreicht werden kann. Zur Objektivierung dieser Fragestellung wurde im Rahmen einer prospektiv, randomisierten Studie bei 20 aseptischen Patienten einer operativen Intensivstation das Stoffwechselverhalten unter differenten Ernährungsbedingungen eingehend untersucht. In einem zehnstündigen Untersuchungszeitraum wurde bei isokalorischer (Kohlenhydrate: 0,25 g/kg KG/h, Fett: 0,166 g/kg KG/h) und isonitrogener (Aminosäuren: 0,0625 g/kg KG/h) Gesamtzufuhr der unterschiedliche Einfluß eines Glukose-/Fett- vs. Fruktose-/Fett-Regimes auf verschiedene Parameter des Kohlenhydrat- und Fettstoffwechsels verglichen. Anhand eines signifikant geringeren Blutglukose- (Anstieg gegenüber Ausgangswert: Glukose-/Fett: p〈0,001; Fruktose-/Fett: n.s.) und Insulinanstiegs (Anstieg gegenüber Ausgangswert: Glukose-/Fett: p〈0,001; Fruktose-/Fett: p〈0,01) ließ sich eine den Glukosestoffwechsel kaum beeinflussende Wirkung der Fruktose nachweisen. Eine Beeinträchtigung der Glukoseverwertung durch gleichzeitige Fettapplikation ließ sich unabhängig davon, ob die Patienten primär Glukose oder Fruktose erhielten, nicht beobachten. Die Untersuchungsergebnisse haben gezeigt, daß während des sog. Postaggressionsstoffwechsels die gleichzeitige Verabreichung von Fruktose und Fett die Glukosehomöostase signifikant weniger beeinflußt als die Applikation von Glukose als Energieträger.
    Type of Medium: Electronic Resource
    Signatur Availability
    BibTip Others were also interested in ...
  • 4
    Electronic Resource
    Electronic Resource
    Amsterdam : Elsevier
    Icarus 73 (1988), S. 1-14 
    ISSN: 0019-1035
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Physics
    Type of Medium: Electronic Resource
    Signatur Availability
    BibTip Others were also interested in ...
  • 5
    Electronic Resource
    Electronic Resource
    [s.l.] : Nature Publishing Group
    Nature 383 (1996), S. 415-417 
    ISSN: 1476-4687
    Source: Nature Archives 1869 - 2009
    Topics: Biology , Chemistry and Pharmacology , Medicine , Natural Sciences in General , Physics
    Notes: [Auszug] For determining the distribution of total mass from stellar dynamics without the a priori assumption of isotropic motions it is necessary to determine both the radial and proper motions of the stars. For this purpose we have been carrying out since 1991 a programme of high resolution 2.2-um (K ...
    Type of Medium: Electronic Resource
    Signatur Availability
    BibTip Others were also interested in ...
  • 6
    Electronic Resource
    Electronic Resource
    [s.l.] : Nature Publishing Group
    Nature 355 (1992), S. 526-529 
    ISSN: 1476-4687
    Source: Nature Archives 1869 - 2009
    Topics: Biology , Chemistry and Pharmacology , Medicine , Natural Sciences in General , Physics
    Notes: [Auszug] We report here the results of two recent experiments. First, we used the new MPE near-infrared high-resolution camera, SHARP, at the New Technology Telescope (NTT) of the European Southern Observatory (ESO) at La Silla, Chile, for near-diffraction-limited imaging at H (1.6 |xm) and K ...
    Type of Medium: Electronic Resource
    Signatur Availability
    BibTip Others were also interested in ...
  • 7
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    ISSN: 1749-6632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Natural Sciences in General
    Notes: The Galactic center is a superb laboratory of modern astrophysics where astronomers can study at unprecedented spatial resolution and across the entire electromagnetic spectrum physical processes that may also happen at the cores of other galaxies. Following a brief review of the phenomena observed in the central few hundred parsecs, we discuss two main issues in more detail. The source(s) of luminosity in the central parsec and the nature of the compact radio source SgrA*, the most likely candidate for a massive central black hole.
    Type of Medium: Electronic Resource
    Signatur Availability
    BibTip Others were also interested in ...
  • 8
    ISSN: 1476-4687
    Source: Nature Archives 1869 - 2009
    Topics: Biology , Chemistry and Pharmacology , Medicine , Natural Sciences in General , Physics
    Notes: [Auszug] Recent measurements of stellar orbits provide compelling evidence that the compact radio source Sagittarius A* (refs 4, 5) at the Galactic Centre is a 3.6-million-solar-mass black hole. Sgr A* is remarkably faint in all wavebands other than the radio region, however, ...
    Type of Medium: Electronic Resource
    Signatur Availability
    BibTip Others were also interested in ...
  • 9
    ISSN: 1476-4687
    Source: Nature Archives 1869 - 2009
    Topics: Biology , Chemistry and Pharmacology , Medicine , Natural Sciences in General , Physics
    Notes: [Auszug] Many galaxies are thought to have supermassive black holes at their centres—more than a million times the mass of the Sun. Measurements of stellar velocities and the discovery of variable X-ray emission have provided strong evidence in favour of such a black hole at the centre of the ...
    Type of Medium: Electronic Resource
    Signatur Availability
    BibTip Others were also interested in ...
  • 10
    Electronic Resource
    Electronic Resource
    Amsterdam : Elsevier
    Infrared Physics and Technology 35 (1994), S. 487-491 
    ISSN: 1350-4495
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Physics
    Type of Medium: Electronic Resource
    Signatur Availability
    BibTip Others were also interested in ...
Close ⊗
This website uses cookies and the analysis tool Matomo. More information can be found here...