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  • Articles  (132)
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  • 1
    Electronic Resource
    Electronic Resource
    Amsterdam : Elsevier
    Polyhedron 10 (1991), S. 1239-1245 
    ISSN: 0277-5387
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Chemistry and Pharmacology
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Bien qu'un seul antibiotique avec un large spectre couvrant les germes aérobies et anaérobies soit reconnu comme efficace dans l'appendicite, beaucoup de chirurgiens continuent d'utiliser une polyantibiothérapie. Dans un essai contrôlé en double aveugle, nous avons testé la corrélation clinique avec la sensibilité in vitro d'une association de plusieurs antibiotiques comme traitement complémentaire chez 114 patients ayant eu une appendicite compliquée. Quatre-vingt pour-cent (36/40) des patients ayant eu du céfotétan et 86% (31/36) des patients ayant eu l'association clindamycine/amikacíne n'ont pas eu de complications infectieuses postopératoires (p=0.11). II a été nécessaire de changer les antibiotiques en raison d'une complication postopératoire plus souvent chez les patients ayant eu l'association clindamycine/amikacine, 5 (12%) comparé à 1 (2%) dans le groupe céfotétan (p=0.07). On a identifié des organismes Bacteroides fragilis résistants au céfotétane mais aucun n'était responsable d'infection postopératoire. II y a eu des effets secondaires non désirables, essentiellement une perturbation des tests de la fonction hépatique, chez 28% et chez 26% des patients ayant pris respectivement du céfotétane et l'assocíation clindamycine/amikacine, respectivement. Une monothérapie avec une céphalosporine de deuxième génération du type céfotétan, donnée deux fois par jour, est ffficace et économique dans le traitement de l'appendicite compliquée mais opéréc. Les aminosides et les autres antibiotiques plus puissants doivent être réservés pour les germes résistants ou les infections nosocomiales.
    Abstract: Resumen Aunque los antibióticos únicos de amplio espectro de cobertura aeróbica y anaeróbica son eficaces en la apendicitis, muchos cirujanos continúan utilizando agentes múltiples. Se diseñó un ensayo clínico prospectivo, doble ciego y aleatorizado con el fin de correlacionar la susceptibilidad in vitro de agentes antimicrobianos múltiples como terapia adyuvante en el manejo de 114 pacientes sometidos a operación por apendicitis complicada. 90% (36/40) de los pacientes en el Grupo de cefotetan y 86% (31/36) en el Grupo que recibió clindamicina/amikacina tuvieron resolución clínica de sus infecciones intraabdominales sin recurrencia de complicaciones sépticas postoperatorias (P=0.11). El número de pacientes que tuvieron cambio en la terapia antibiótica por complicaciones postoperatorias fue más alto en el Grupo clindamicina/amikacina, 5 (12%) comparados con 1 (2%) en el Grupo cefotetan (P=0.07). Aunque se identifícaron microorganismos del Grupo de los Bacteroides fragilis resistentes a cefotetan, ninguno fue responsable de infecciones postoperatorias. Se presentaron reacciones farmacológicas adversas en 28% del Grupo cefotetan y en 26% del Grupo clindamicina/amikacina, las cuales consistieron primordialmente en elevaciones pasajeras de los valores de las pruebas de función hepática. La monoterapia con una cefalosporina de amplio espectro de segunda generación, tal como el cefotetan, administrado en dos dosis diarias constituye un régimen económico y eficaz en la apendicitis complicada en la cual la cirugía representa el tratamiento definitivo. Los aminoglucósidos y otros agentes antimicrobianos más potentes deben ser reservados para el tratamiento de infecciones nosocomiales por microorganismos resistentes.
    Notes: Abstract Although single antimicrobials with broad-spectrum aerobic and anaerobic coverage are effective in patients with appendicitis, many general surgeons continue to use multiple agents. A prospective, doubleblind, randomized trial was designed to detect any clinical correlate of in vitro susceptibility advantage of multiple antimicrobials as adjunctive therapy for 114 patients undergoing operation for complicated appendicitis. There was clinical resolution of intraabdominal infections with no occurrence of postoperative infectious complications in 90% (36 of 40) of the cefotetan group and 86% (31 of 36) of the clindamycin/amikacin group (p=0.11). The number of patients who had changes in antibiotic therapy due to postoperative complications was higher in the clindamycin/amikacin group: five (12.5%), compared to one (2.8%) in the cefotetan group (p=0.07). Although Bacteroides fragilis group organisms resistant to cefotetan were identified, none was responsible for the postoperative infections. Adverse drug events in 28% of the cefotetan group and 26% of the clindamycin/amikacin group consisted primarily of transient elevations of liver function tests. Monotherapy with a second-generation, broad-spectrum cephalosporin, such as cefotetan, given twice a day is an economical and effective adjunctive regimen in patients with complicated appendicitis for which operation is the definitive treatment. Aminoglycosides and other, more potent antimicrobials should be reserved for resistant organisms or nosocomial infections.
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  • 3
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé L'article rapporte 3 cas de nécrose duodénale insoupÇonnée avec perforation, survenant de 2 à 4 semaines après traitement initialement efficace de pancréatite aigue hémorragique. L'exploration chirurgicale fut rendue nécessaire par l'apparition de fièvre, masse abdominale et signes radiologiques d'abcès d'intra-abdominaux. Le traitement chirurgical consista en drainage des abcès pancréatiques et rétroduodénaux, et fermeture de la fistule duodénale. Le'duodénum fut décomprimé à l'aide d'un tube endoluminal introduit par gastrostomie. En période post-opératoire les patients furent traités par hyperalimentation parentérale totale, antibiothérapie spécifique et radiographie répétées pour localiser la formation de nouveaux abcès intra-abdominaux. Tous les patients durent Être réopérés de une à quatre reprises à cause de nécrose pancréatique persistante et abcédation. La pancréatite nécrosante avec infection rétropéritonéale persistante et fistulisation s'accompagne d'une morbidité grave, d'une période d'hospitalisation de plusieurs mois et est actuellement la principale cause de décès chez les patients porteurs de pancréatite. La survie de ces 3 patients est attribuable au drainage précoce des abcès péritonéaux, et aux progrès réalisés dans le traitement des fistules duodénales.
    Notes: Abstract Acute necrotizing pancreatitis associated with occult duodenal necrosis and perforation developed in 3 patients 2 to 4 weeks after initially successful treatment of hemorrhagic pancreatitis. Exploration was required for fever, abdominal mass, or X-ray findings of an intra-abdominal abscess. At operation all pancreatic and retroperitoneal abscesses were drained with sump tubes, and the duodenal fistula was closed. An intraluminal tube, placed via a gastrostomy, was used for decompression of the duodenum. Postoperative management included total parenteral nutrition, antibiotics specific for aerobic and anaerobic flora, and frequent X-rays to locate new intra-abdominal abscesses. One to 4 reoperations were necessary because of continuing pancreatic necrosis and abscess formation in each patient. Necrotizing pancreatitis with unrelenting retroperitoneal sepsis and fistula formation results in serious morbidity, hospital stays of several months, and is now the major cause of death in patients with pancreatitis. Survival of all 3 patients resulted from drainage of evolving retroperitoneal abscesses and improvement in our technique for management of large duodenal fistulas.
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  • 4
    ISSN: 1432-0509
    Keywords: Appendix-mucocele ; Colon-intussusception
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Intussusception by an appendiceal mucocele into the colon is illustrated and the literature reviewed.
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  • 5
    ISSN: 1432-0509
    Keywords: Abdominal ultrasound ; Intussusception ; Infiltrating carcinoma of pyloric antrum ; Bowel loops
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Gray scale ultrasound examination of two patients with abdominal space-occupying lesions demonstrated characteristic ring shadows on longitudinal scans. In one case a multiple concentric ring shadow resulted from an ileocolic intussusception, and in the other a “bull's eye” image was due to an infiltrating carcinoma of the pyloric antrum. A study of these patients confirms the suspicion [1] that there is a characteristic ultrasonic appearance of intussusception in bowel loops.
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  • 6
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Aim: To investigate the effect of Bio-Oss® with and without the local application of recombinant human platelet-derived growth factor (rhPDGF-BB) on bone formation under Teflon capsules.Materials and Methods: Eight male, 6-month-old, Wistar strain rats were used in the study. In each animal, the lateral aspect of the mandibular ramus was exposed and small perforations were produced in the bone. A rigid, non-porous hemispherical teflon capsule (diameter 7 mm) was placed on the ramus in both sides of the animals. The capsule placed on the one side of the jaw was filled with Bio-Oss® granules soaked in a solution of PDGF-BB (20 μg/capsule) and autogenous blood prior to placement. The capsules placed on the other side of the jaw were filled with Bio-Oss® granules soaked in autogenous blood only (controls). Four rats were sacrificed after 3 months and the remaining four after 5 months. Undecalcified sections containing the capsule and surrounding tissues were prepared and analysed in the microscope.Results: Histologic analysis revealed limited amounts of bone formation. Most of the space underneath the capsules was occupied by Bio-Oss® particles surrounded by fibrovascular connective tissue. Given the small sample size statistical analysis was not possible, however, the mean amount of mineralized new bone in the control group (20.8%) appeared to be larger than that in the test group (6.7%). After 5 months the amount of newly formed bone appeared similar in the two groups (23.0% test, 26.0% controls). The Bio-Oss® particles occupied between 31.4% and 41.1% of the capsule area at 3 months and between 34.0% and 34.7% at 5 months. Only particles adjacent to the mandibular ramus were incorporated in newly formed bone.Conclusion: Limited bone formation was present in the capsules grafted with Bio-Oss® with or without the growth factor.
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  • 7
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Aim: To evaluate whether bone formation under Teflon capsules may be enhanced by concomitant implantation of recombinant human platelet-derived growth factor-BB/insulin-like growth factor-I (rhPDGF-BB/IGF-I) incorporated into a methyl cellulose gel.Materials and Methods: Fifty-five male 6-month-old albino rats of the Wistar strain were used in the study. The lateral aspect of the mandibular ramus was exposed on both sides of the jaw. In 70 sites, the periosteum was removed from the ramus, leaving the bone denuded, while in 35 sites, it was preserved. On 10 non-periosteal (P−) sites and five periosteal (P+) sites, an empty rigid teflon capsule (d=7 mm), serving as control, was placed on the ramus. In the 40 test animals, the capsule placed on the one side of the jaw was filled at random with one of three different concentrations (1200, 600, 150 μg/ml) of rhPDGF-BB/IGF-I gel. The capsules placed on the contralateral side of the jaw contained a placebo methyl cellulose gel. Each growth factor group, defined according to the gel concentration, and the placebo group contained 10 capsules placed on the P− side and five capsules placed on the P+ side. Two months after surgery, all animals were sacrificed.Results: Histologic analysis revealed that in the non-filled control capsules, the amount of new bone including the bone marrow was 29.9% and 39.7% of the capsule area on the P− and P+ sides, respectively. In the test capsules with the growth factor gel and placed on the P−sides, the amounts of new bone ranged from 5.6% to 6.3%, which were similar (p〉0.05) to that formed in the capsules filled with the methyl cellulose gel (5.5%). New bone formation was larger in the capsules on the P+ sides than in those on the P− sides but was similar in the capsules with different growth factor concentrations (range 17.9–19.6%) and in those with placebo gel (21.0%). In all groups, the carrier gel was poorly absorbed and occupied most of the capsules.Conclusion: Local application of a methyl cellulose gel obstructed bone formation under Teflon capsules placed adjacent to uninjured cortical bone in the mandibular ramus of rats. These data suggest that another material should be utilized to deliver growth factors under Teflon membranes for guided bone regeneration.
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  • 8
    ISSN: 1600-051X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The aim of this study was to investigate the accuracy and reproducibility of experienced and inexperienced examiners using 3 automated periodontal probes (Florida Pocket Probe, Florida Disk Probe, Peri Probe) in comparison with 3 conventional periodontal probes (Marquis, Williams and EN-15 probes. Test blocks of aluminium had 30 holes of diameter 1.10 mm and depths ranging from 2.75 to 10.0 mm. machined with a tolerance of ±0.01 mm. 8 experienced examiners and 8 inexperienced examiners were selected to perform duplicate measurements on the blocks over 6 visits using each of the, 6 probes. 1 automated and 1 conventional probe were used at each examination. The % accuracy and reproducibility for each of the duplicate measurements was calculated and analysed using Friedman 2-way analysis of variance and the Wilcoxon matched pairs test. On average, all probes showed high reproducibility, with the Florida Disk Probe, the Florida Pocket Probe and the Williams probe ranked best and the other 3 probes were less reproducible. On average, all probes showed a high degree of accuracy, automated probes were ranked best and were significantly better than conventional probes. Experience had little effect on reproducibility. with only the Peri Probe showing significant differences at the 5% level between the groups. Experience appeared to be more important for accuracy, as experienced examiners were more accurate than inexperienced examiners, with significant differences at the 5% level for the EN-15. Florida Disk Probe and Peri Probe. However, inexperienced examiners were significantly more accurate using the Williams probe. This in vitro study has shown that automated probes offer increased accuracy over conventional probes and the Florida Pocket and disk probes compare well with conventional probes for reproducibility.
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  • 9
    Electronic Resource
    Electronic Resource
    [s.l.] : Nature America Inc.
    Nature structural biology 6 (1999), S. 212-216 
    ISSN: 1072-8368
    Source: Nature Archives 1869 - 2009
    Topics: Biology , Medicine
    Notes: [Auszug] The hairpin ribozyme is a small catalytic RNA with a unique two-domain structure. Here we present the solution structure of the loop B domain of the hairpin ribozyme, which contains most of the catalytically essential nucleotides. The 38-nucleotide domain contains a 16-nucleotide internal loop ...
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  • 10
    ISSN: 1072-8368
    Source: Nature Archives 1869 - 2009
    Topics: Biology , Medicine
    Notes: [Auszug] Sir—It has long been appreciated that calmodulin (CaM) relies on its conformational plasticity to accomplish its diverse regulatory functions, regulating a large number of different target enzymes and structural proteins. Recent nuclear magnetic resonance (NMR) and crystallographic studies of ...
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