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IntensiveMedizin.00370507.eng.abstr
|
IntensiveMedizin.00370507.eng.abstr
|
[
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"text": [
"The hemodynamic treatment of septic shock consists of fluid repletion , maintenance of an adequate cardiac output , and restoration of mean arterial pressure . Norepinephrine is a potent vasopressor that can be considered when the patient is adequately fluid resuscitated , when cardiac output is greater than 3.5 l/min/m2 ( or Sv O2>=65%) and when blood pressure remains low . The objective is to achieve and maintain a mean arterial pressure of 60-70 mmHg , or more in some patients ( older or hypertensive patients ) . Renal effects of norepinephrine were evaluated in several studies ; urine output , creatinine clearance , and osmolar clearance are significantly increased . Norepinephrine is perfectly suited in situations of high renal output and low renal resistance , as is the case in septic shock patients . The effect on oxygen transport is unpredictable . The effects on lactate concentrations were poorly evaluated , but several studies suggest that the drug does not worsen and can even improve tissue oxygenation of septic shock patients . Provided that cardiac output is maintained , treatment with norepinephrine is without negative effects on splanchnic tissue oxygenation . In conclusion , the clinical experience with norepinephrine strongly suggests that this drug can successfully increase blood pressure without deteriorating cardiac output and organ function . Whether using norepinephrine in septic shock patients effects mortality as compared to dopamine or epinephrine still requires a prospective study ."
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] |
[] |
[] |
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] |
IntensiveMedizin.00370536.eng.abstr
|
IntensiveMedizin.00370536.eng.abstr
|
[
{
"id": "IntensiveMedizin.00370536.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Nosocomial pneumonia is still a common problem , especially in intubated and mechanically ventilated patients . The endotracheal tube contributes substantially to the pathogenesis of pneumonia in these patients , because it facilitates microaspiration and impairs host defense . Common nosocomial pathogens like Pseudomonas aeruginosa are known to produce exopolysaccharides and generate a complex biofilm structure , which allows adhesion to abiotic surfaces and protection against antibiotic action . Multiple studies have identified bacterial biofilm on the inner lumen of endotracheal tubes , which represents a permanent source of infectious material . Endotracheal tubes , removed from patients with ventilator-associated pneumonia , are covered more frequently with biofilm than those of uninfected controls . It remains unclear whether this represents a source of infection or contamination . Bacterial biofilm , however , may play an important role in recurrent pulmonary infections of the intubated and mechanically ventilated patient ."
],
"offsets": [
[
0,
1046
]
]
}
] |
[
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"text": [
"pneumonia"
],
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11,
20
]
],
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] |
[] |
[] |
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IntensiveMedizin.00370541.eng.abstr
|
IntensiveMedizin.00370541.eng.abstr
|
[
{
"id": "IntensiveMedizin.00370541.eng.abstr-passage-0",
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"text": [
"A fundamental change in the way we think about acid-base homeostasis has been on the horizon for some time . Modern advances in cell biology and physiology now permit us to explain the inconsistencies in the traditional approaches to acid-base that have been identified by physical chemistry for decades . Furthermore , the widespread availability of personal computers has permitted the application of these principles to clinical medicine . In the ICU , patients frequently manifest extreme examples of acid-base imbalance . The understanding of the genesis of many these abnormalities as well as the approach to treatment are profoundly affected by this new paradigm . Common disorders such as suction alkalosis , dilutional acidosis , and lactic acidosis are among the best examples ."
],
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[
0,
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}
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[] |
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] |
IntensiveMedizin.00370549.eng.abstr
|
IntensiveMedizin.00370549.eng.abstr
|
[
{
"id": "IntensiveMedizin.00370549.eng.abstr-passage-0",
"type": "abstract",
"text": [
"We examined the correlation between two different methods to measure cardiac output in 12 patients with chronic heart failure ( NYHA III-IV ) . Using a Swan-Ganz catheter ( Baxter 746H-8F) we measured cardiac output according to the thermodilution bolus method and to the continuous thermodilution method , which works automatically by delivering pulses of energy from a thermal filament on the catheter . Sodium nitroprusside was infused in four increasing doses . Every 60 minutes , the dose was increased . We performed measurements at 11 time points ( 3 at baseline and 8 every 30 minutes during application of sodium nitroprusside ) . Statistical analysis was calculated according to the Spearman formula . Results : The values for cardiac output by the thermodilution bolus method and the continuous method showed significant correlation at 8 of 11 time points . Conclusion : The continuous method allows fast and reliable measurement of cardiac output while pharmacologically changing hemodynamics ."
],
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] |
IntensiveMedizin.00370555.eng.abstr
|
IntensiveMedizin.00370555.eng.abstr
|
[
{
"id": "IntensiveMedizin.00370555.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Coronary artery occlusion followed by myocardial infarction in the setting of nonpenetrating chest trauma is extremely rare . Before the advent of percutaneous transluminal coronary angioplasty ( PTCA ) , the only treatment option for coronary artery occlusion after chest trauma was supportive therapy or coronary artery bypass grafting . We report a case of myocardial infarction after occlusion of the right coronary artery ( RCA ) , presumably due to a dissection of the proximal segment . A previously healthy 36 year old man without risk factors of coronary heart disease was involved in a car accident and subsequently admitted to the emergency ward with a blunt chest trauma . On day four , the ECG showed signs of posterior myocardial infarction . The left ventricular posterior wall was akinetic on echocardiography . Due to these echocardiographic findings and ECG changes , a coronary angiography was performed which showed an angiographically normal left coronary artery . However , the RCA was dissected shortly after its origin . RCA revascularization was achieved by PTCA and stenting of the dissected segment with a good angiographic result . The subsequent clinical course was uneventful ."
],
"offsets": [
[
0,
1207
]
]
}
] |
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] |
[] |
[] |
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IntensiveMedizin.00370561.eng.abstr
|
IntensiveMedizin.00370561.eng.abstr
|
[
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"text": [
"In cardiac emergencies , the correct diagnosis of the underlying cause is the first step to optimal treatment . For accurate and effective decision-making in cardiac emergencies , careful search for clues during the physical examination and an informed and systematic approach to the 12-lead electrocardiogram ( ECG ) is necessary . Important physical findings in supraventricular tachycardias are neck vein pulsations ( \" frog sign \" ) ; this sign is typical for the presence of AV nodal reentrant or circus movement tachycardias . In atrial fibrillation , irregular pulsations in the neck veins are present . The physical signs of AV dissociation ( present in ~ 50% of all ventricular tachycardias ) are irregular A waves in the jugular pulse , beat-to-beat changes in systolic blood pressure and varying intensity of the first heart sound . Typical ECG signs are visible during sinus rhythm in some patients at risk for life-threatening ventricular arrhythmias and/or sudden death . The most common type is preexcitation ( WPW syndrome ) with the trias - wave , short PR interval and ST segment depression . In the Brugada syndrome the ECG typically shows right bundle branch block with ST segment elevation in leads V1-V3. The predominant feature in the long QT syndrome is QT prolongation ; the QT interval in these pts is > 550ms , the QTc averages > > 0.39s in males and > 0.44s in females . Arrhythmogenic right ventricular ( RV ) dysplasia/ cardiomyopathy is characterized by peculiar RV involvement and electrical instability . Epsilon waves or localized prolongation ( > 110ms ) of QRS in V1-V3 with/without inverted T waves in V2-V3 are typical ECG findings . Careful physical examination and correct interpretation of the ECG in the emergency situation leads to a better outcome for many of the patients . Correct treatment based on an understanding of the mechanism that caused the cardiac emergency may not only be lifesaving in the immediate situation but may also improve the quality of life ."
],
"offsets": [
[
0,
2010
]
]
}
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}
] |
[] |
[] |
[
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IntensiveMedizin.00370573.eng.abstr
|
IntensiveMedizin.00370573.eng.abstr
|
[
{
"id": "IntensiveMedizin.00370573.eng.abstr-passage-0",
"type": "abstract",
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"The use of semi-automated defibrillators by trained nonprofessional rescuers allows for enhanced success of the chain of survival after sudden cardiac death . In the setting of professional resuscitation , the effectiveness of electrical defibrillation to convert life-threatening ventricular tachyarrhythmias into a more stable rhythm is well established . The current article describes how defribillation can also be employed by nonprofessional witnesses of sudden cardiac death and how this can be expected to increase survival . The main focus is on training of nonprofessionals , the required materials , realization of the chain of survival , scientific documentation and control , and legal aspects . In any situation with many individuals assembled , semi-automated defribillators can readily and effectively be used to treat a patient with sudden cardiac death . This can be expected to substantially improve the generally unfavorable outcome of such patients ."
],
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[
0,
970
]
]
}
] |
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"patients"
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{
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}
] |
[] |
[] |
[
{
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{
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{
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},
{
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},
{
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{
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},
{
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},
{
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},
{
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{
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{
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{
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"normalized": []
}
] |
IntensiveMedizin.00370597.eng.abstr
|
IntensiveMedizin.00370597.eng.abstr
|
[
{
"id": "IntensiveMedizin.00370597.eng.abstr-passage-0",
"type": "abstract",
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"Prognostic assessment of acute global cerebral anoxia following cardiorespiratory arrest requiresa high level of clinical and technical diagnostic skills . Statements regarding prognosis of this form of coma can be made only with reference toa large number of clinical , neurophysiological , biochemical , and cerebral imaging data . Previous research in this field has usually been restricted to only one or a few parameters such as clinical data , EEG findings , evoked potentials or biochemical markers . The present compilation of the various aspects regarding diagnosis and prognosis is intended to define the present state of the art in diagnosis and prognosis of anoxic coma , and also serve as a basis for a multicenter prospective study including all of the relevant data to improve diagnosis and arrive at guidelines for effective prognostication of anoxic coma ."
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] |
IntensiveMedizin.00370625.eng.abstr
|
IntensiveMedizin.00370625.eng.abstr
|
[
{
"id": "IntensiveMedizin.00370625.eng.abstr-passage-0",
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"text": [
"Systemic lupus erythematosus ( SLE ) is an autoimmune disease which occurs in over 80% in women during childbearing years . We report the case of a 69 year old man with known SLE who was admitted to our hospital because of dyspnea and pleuritic chest pain . Radiology showed diffuse acinar infiltrates in the lower lung fields . Because of progressive respiratory failure , intubation and mechanical ventilation was necessary . The radiographic findings had changed and diffuse alveolar opacities were documented . The chest HR-CT showed a bibasilar ground glass appearence and diffuse alveolar interstitial infiltrates . Bronchoscopy was performed and pulmonary hemorrhage was found . After exclusion of a pulmonary infection , immunosuppressive therapy with systemic corticosteroids and cyclophophamide was started because of the suspicion of lupus pneumonitis and diffuse alveolar hemorrhage syndrome . Two days later , the patient died of septic shock in spite of antibiotic therapy . Our suspicion could be confirmed by histology of the lung . Acute lupus pneumonitis ( 1-12% ) and the alveolar hemorrhage syndrome ( 10-20% ) are uncommon complications in SLE with a mortality rate of more than 50% . If the outcome is to be improved , diagnosis has to be established timely and immunosuppressive therapy has to be started immediately ."
],
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] |
[] |
[] |
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IntensiveMedizin.00370631.eng.abstr
|
IntensiveMedizin.00370631.eng.abstr
|
[
{
"id": "IntensiveMedizin.00370631.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Emergency medicine and critical care are fields that often require rapid diagnosis and intervention for specific situations . Narrow QRS tachycardia is a cardiac rhythm with a rate faster than 100/min and a QRS duration 0.12 s. Causes of narrow QRS tachycardia ( N-QRS-T ) are sinus tachycardia ( ST ) , atrial tachycardia ( AT ) , AV nodal reentry tachycardia ( AVNRT ) , circus movement tachycardia ( CMT ) , atrial flutter ( AFlut ) and atrial fibrillation ( AFib ) . A systematic ECG approach with evaluation of spontaneous AV block , QRS alternans , P wave location and P wave polarity permits correct identification of the underlying arrhythmia mechanism and the origin of the arrhythmia . In hemodynamically unstable N-QRS-T , electrical DC cardioversion should be performed immediately . If the hemodynamic situation is stable , vagal maneuvers ( Valsalva , carotis sinus massage ) are indicated ; if unsuccessful , drugs are therapeutic alternatives . In ST , beta-blocking agents ( metoprolol 15 mg i.v. ) are successful ; in AT and AVNRT adenosine ( 6-18 mg bolus i.v. ) and ajmaline ( 50-100 mg i.v. ) are preferred . In patients ( pts ) with CMT , ajmaline ( 50-100 mg i.v. ) is an ideal drug with high success rates . When vagal maneuvers or pharmacologic interventions fail to suppress the N-QRS-T , DC cardioversion is necessary . For pts with AFib principles of therapy are restoration of sinus rhythm ( RSR ) or ventricular rate control . Direct current cardioversion can restore sinus rhythm in up to 90% of pts with AFib . No single agent has emerged as the drug of choice for converting AFib ; however , RSR is possible with propafenone ( 600 mg oral ) , flecainide ( 300mg oral ) or sotalol ( 80-160 mg oral ) . Ventricular rate control is an important component in pts with AFib . Verapamil ( 5-10 mg i.v. ) and digoxin ( 0.4 mg i.v. ) are effective drugs in reducing resting ventricular rates in pts with established AFib . Three options are available for acute treatment of AFlut : rapid atrial pacing , DC cardioversion or administration of propafenone ( 600 mg oral ) or flecainide ( 300 mg oral ) ."
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] |
[] |
[] |
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] |
IntensiveMedizin.70340005.eng.abstr
|
IntensiveMedizin.70340005.eng.abstr
|
[
{
"id": "IntensiveMedizin.70340005.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The term \" ecstasy \" comprises many different hallucinogenic amphetamines , of which the most prominent representatives are MDMA ( 3,4-methylenedioxy-methamphetamine) and MDEA ( 3,4-methylenedioxyethamphetamine ) . Apart from these and related active substances there are additional substances to be found in the offered preparations ( e . g . , amphetamine , ephedrine , selegiline , paracetamol ) , which can modify the effect and the symptoms of ecstasy to a great extent . In Germany , the use of ecstasy and thus the frequency of complications after the ingestion of ecstasy has increased immensely in recent years . Consequently , there is a growing need for knowledge and strategies to deal with medical complications caused by ecstasy ."
],
"offsets": [
[
0,
744
]
]
}
] |
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IntensiveMedizin.70340014.eng.abstr
|
IntensiveMedizin.70340014.eng.abstr
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"Bacterial infections are still a significant cause of morbidity , mortality and increased hospital costs , particularly in intensive care units . Antibiotic therapy in intensive care units is usually empirical , with the best suitable antibiotics chosen based on their properties , previous experience , local antibiograms , and familiarity , until the specific infecting pathogen has been identified and the antimicrobial susceptibility is known . Most institutions continue to employ a combination of a -lactam and an aminoglycoside for the empirical therapy , but therapy with a single agent like Ceftazidim , Carbapenem , Piperacillin/Tazobactam or Ciprofloxacin appears to be equally effective in many situations . Deescalating treatment sequentially from an initial combination treatment until the specific infecting pathogen has been identified and the antimicrobial susceptibility is known to a second phase with a tailored therapy for the individual patient is discussed in this paper . Infections caused by both common and rare bacteria can be treated successfully in the vast majority of cases . Nevertheless , multidrug-resis-tant pathogens in intensive care units have shown alarming increases in many countries . Multi-resistant Enterobacteriaceae , Pseudomonas , Stenotrophomonas , Staphylococci and Enterococci may be selected by increasing antibiotic pressure . Strategies to stabilize and contain antibiotic resistance in local areas can succeed in prolonging the useful life of antibiotics . Preventing transmission of infection now needs to be coupled with improved antibiotic use ."
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] |
IntensiveMedizin.70340024.eng.abstr
|
IntensiveMedizin.70340024.eng.abstr
|
[
{
"id": "IntensiveMedizin.70340024.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Excessive bleeding frequently complicates the care of critically-ill patients . Except in the case of trauma or in patients with known coagulopathies ( e.g. , hemophilia ) , the bleeding is generally not directly related to the illness that results in admission to the intensive care unit . In general , the causes of the bleeding can be divided into 3 categories : consumptive coagulopathies ( e.g. , DIC ) , bleeding related to \" hepatic issues \" ( i.e. , liver dysfunction , vitamin K deficiency ) , and iatrogenic causes . This review will discuss the more common causes of bleeding in the critically-ill patient and outline diagnostic and treatment approaches for these patients . New experimental data linking activation of the coagulation and inflammatory systems with the development of multisystem organ failure is briefly discussed ."
],
"offsets": [
[
0,
843
]
]
}
] |
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IntensiveMedizin.70340033.eng.abstr
|
IntensiveMedizin.70340033.eng.abstr
|
[
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[] |
[] |
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] |
IntensiveMedizin.70340040.eng.abstr
|
IntensiveMedizin.70340040.eng.abstr
|
[
{
"id": "IntensiveMedizin.70340040.eng.abstr-passage-0",
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],
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[
0,
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]
]
}
] |
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"id": "IntensiveMedizin.70340040.eng.abstr-s1-t5",
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72,
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"db_id": "C0022660"
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"id": "IntensiveMedizin.70340040.eng.abstr-s2-t1",
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161,
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{
"id": "IntensiveMedizin.70340040.eng.abstr-s2-t2",
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"care"
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203,
207
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"id": "IntensiveMedizin.70340040.eng.abstr-s2-t3",
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215,
223
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"id": "IntensiveMedizin.70340040.eng.abstr-s2-t4",
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143,
168
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] |
[] |
[] |
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"type": "associated_with",
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] |
IntensiveMedizin.70340046.eng.abstr
|
IntensiveMedizin.70340046.eng.abstr
|
[
{
"id": "IntensiveMedizin.70340046.eng.abstr-passage-0",
"type": "abstract",
"text": [
"A 24-year-old type I diabetic suffered from recurrent episodes of severe diabetic ketoacidosis ( serum bicarbonate 7.9 and 4.3 mmol/l , respectively ) following intoxication with synthetic drugs ( \" Ecstasy \" and \" Speed \" ) . Despite poor diabetic control ( HbA1c 11.7% ) insulin was omitted while drugs were taken . Dancing for hours at a Technoparty without adequate volume replacement preceded his first urgent admission to hospital . The clinical picture disclosed dehydration , tachycardia and abdominal symptoms ( peritonism ) . Clouding of consciousness , agitation and delusions were attributed to drug consumption . Therapy included intravenous fluid replacement , correction of electrolyte disturbances and application of insulin . The clinical courses were unremarkable ."
],
"offsets": [
[
0,
783
]
]
}
] |
[
{
"id": "IntensiveMedizin.70340046.eng.abstr-s1-t1",
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114
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{
"id": "IntensiveMedizin.70340046.eng.abstr-s1-t2",
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173
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{
"id": "IntensiveMedizin.70340046.eng.abstr-s1-t3",
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"drugs"
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189,
194
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"db_id": "C0013227"
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},
{
"id": "IntensiveMedizin.70340046.eng.abstr-s1-t4",
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"Ecstasy"
],
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199,
206
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"db_id": "C0115471"
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},
{
"id": "IntensiveMedizin.70340046.eng.abstr-s1-t5",
"type": "umlsterm",
"text": [
"Speed"
],
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215,
220
]
],
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"db_id": "C0002667"
}
]
},
{
"id": "IntensiveMedizin.70340046.eng.abstr-s1-t6",
"type": "umlsterm",
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[
73,
94
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"db_id": "C0011880"
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{
"id": "IntensiveMedizin.70340046.eng.abstr-s2-t1",
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249,
256
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{
"id": "IntensiveMedizin.70340046.eng.abstr-s2-t2",
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259,
264
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"db_id": "C0019018"
}
]
},
{
"id": "IntensiveMedizin.70340046.eng.abstr-s2-t3",
"type": "umlsterm",
"text": [
"insulin"
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273,
280
]
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{
"db_name": "UMLS",
"db_id": "C0021641"
}
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{
"id": "IntensiveMedizin.70340046.eng.abstr-s2-t4",
"type": "umlsterm",
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"drugs"
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[
299,
304
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"db_id": "C0013227"
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]
},
{
"id": "IntensiveMedizin.70340046.eng.abstr-s3-t1",
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"text": [
"Dancing"
],
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[
318,
325
]
],
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},
{
"id": "IntensiveMedizin.70340046.eng.abstr-s3-t2",
"type": "umlsterm",
"text": [
"hospital"
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"offsets": [
[
428,
436
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{
"db_name": "UMLS",
"db_id": "C0019994"
}
]
},
{
"id": "IntensiveMedizin.70340046.eng.abstr-s4-t1",
"type": "umlsterm",
"text": [
"dehydration"
],
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[
470,
481
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0011175"
}
]
},
{
"id": "IntensiveMedizin.70340046.eng.abstr-s4-t2",
"type": "umlsterm",
"text": [
"tachycardia"
],
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[
484,
495
]
],
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{
"db_name": "UMLS",
"db_id": "C0039231"
}
]
},
{
"id": "IntensiveMedizin.70340046.eng.abstr-s4-t3",
"type": "umlsterm",
"text": [
"symptoms"
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[
510,
518
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"db_name": "UMLS",
"db_id": "C0683368"
}
]
},
{
"id": "IntensiveMedizin.70340046.eng.abstr-s5-t1",
"type": "umlsterm",
"text": [
"consciousness"
],
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[
548,
561
]
],
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{
"db_name": "UMLS",
"db_id": "C0009791"
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]
},
{
"id": "IntensiveMedizin.70340046.eng.abstr-s5-t2",
"type": "umlsterm",
"text": [
"delusions"
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[
578,
587
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{
"id": "IntensiveMedizin.70340046.eng.abstr-s5-t3",
"type": "umlsterm",
"text": [
"drug"
],
"offsets": [
[
607,
611
]
],
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{
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"db_id": "C0013227"
}
]
},
{
"id": "IntensiveMedizin.70340046.eng.abstr-s5-t4",
"type": "umlsterm",
"text": [
"consumption"
],
"offsets": [
[
612,
623
]
],
"normalized": [
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"db_name": "UMLS",
"db_id": "C0009830"
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]
},
{
"id": "IntensiveMedizin.70340046.eng.abstr-s5-t5",
"type": "umlsterm",
"text": [
"Clouding of consciousness"
],
"offsets": [
[
536,
561
]
],
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"db_id": "C0009676"
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]
},
{
"id": "IntensiveMedizin.70340046.eng.abstr-s6-t1",
"type": "umlsterm",
"text": [
"Therapy"
],
"offsets": [
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633
]
],
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"db_id": "C0087111"
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{
"db_name": "UMLS",
"db_id": "C0039798"
}
]
},
{
"id": "IntensiveMedizin.70340046.eng.abstr-s6-t2",
"type": "umlsterm",
"text": [
"electrolyte"
],
"offsets": [
[
689,
700
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0013832"
}
]
},
{
"id": "IntensiveMedizin.70340046.eng.abstr-s6-t3",
"type": "umlsterm",
"text": [
"insulin"
],
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[
733,
740
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0021641"
}
]
}
] |
[] |
[] |
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"type": "diagnoses",
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{
"id": "IntensiveMedizin.70340046.eng.abstr-s1-r7-t5.1-t2.2",
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{
"id": "IntensiveMedizin.70340046.eng.abstr-s1-r8-t4.1-t2.1",
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{
"id": "IntensiveMedizin.70340046.eng.abstr-s1-r9-t1.1-t2.1",
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{
"id": "IntensiveMedizin.70340046.eng.abstr-s1-r10-t2.1-t5.1",
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"arg2_id": "IntensiveMedizin.70340046.eng.abstr-s5-t5",
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{
"id": "IntensiveMedizin.70340046.eng.abstr-s1-r11-t1.1-t2.1",
"type": "causes",
"arg1_id": "IntensiveMedizin.70340046.eng.abstr-s6-t1",
"arg2_id": "IntensiveMedizin.70340046.eng.abstr-s6-t2",
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{
"id": "IntensiveMedizin.70340046.eng.abstr-s1-r12-t4.1-t2.1",
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{
"id": "IntensiveMedizin.70340046.eng.abstr-s1-r13-t2.2-t2.1",
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{
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IntensiveMedizin.70340058.eng.abstr
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IntensiveMedizin.70340058.eng.abstr
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"id": "IntensiveMedizin.70340058.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The aim of thrombolysis is reperfusion of an occluded vessel by thrombolytic agents . In acute myocardial infarction thrombolysis has been shown to achieve an early recanalization of an occluded vessel in a high percentage of patients and to reduce mortality significantly . Also , in severe pulmonary embolism with hemodynamic compromise thrombolysis has been shown to stabilize cardiac function and is assumed to reduce mortality . In contrast to thrombolytic therapy , in life-threatening situations such as acute myocardial infarction or severe pulmonary embolism , thrombolysis is regarded as an elective therapy in addition to systemic heparinization in deep venous thrombosis . Whether or not the aim of thrombolysis in deep venous thrombosis - to prevent a postthrombotic syndrome - can be achieved is not proven . Large prospective or randomized studies are still missing . A concomitant anticoagulation or the use of platelet aggregation inhibitors is necessary ."
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}
] |
[] |
[] |
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IntensiveMedizin.70340101.eng.abstr
|
IntensiveMedizin.70340101.eng.abstr
|
[
{
"id": "IntensiveMedizin.70340101.eng.abstr-passage-0",
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"text": [
"Our clinical experience with anti-inflammatory agents in patients with sepsis has been a disappointing one thus far . To better define the role of inflammation and the applicability of immunomodulators in sepsis , we have administered either anti-inflammatory ( leukocyte adhesion complex directed monoclonal antibodies , CD11/18 MAb ) or pro-inflammatory ( recombinant granulocyte colony stimulating factor , G-CSF ) agents in animals challenged with infectious or noninfectious inflammatory stimuli at intra- or extravascular sites . Inhibition of inflammation with CD11/18 MAb , reduced lung injury and improved survival with intravenous ( TV ) tumor necrosis factor ( TNF ) in canines . However , CD11/18 MAb with intrabronchial ( IB ) or intraperitoneal ( IP ) E. coli challenge , although improving lung injury with pneumonia , worsened host defense , hemodynamics and survival . In canines with IP or IB E. coli , or IV endotoxin , prophylactic G-CSF improved host defense , hemodynamics and survival . However , G-CSF with IB E. coli in the canine increased lung dysfunction and with a higher bacterial dose in the rat worsened both lung injury and survival . In additional studies in rats alone , the effects of prophylactic G-CSF on survival were fundamentally different , depending upon the site and the lethality of E. coli challenge . In a final study , canines were challenged with IP E. coli and then treated with G-CSF therapeutically . Despite using a range of doses , G-CSF did not improve any parameter of outcome in these studies and in very high doses appeared harmful . In our animal models , both pro- and anti-inflammatory agents had widely divergent effects on organ injury and survival . The disparate roles of inflammation in host defense and tissue injury may in part explain these results . Altering the inflammatory response during sepsis is more complicated than we originally expected . For pro- and anti-inflammatory agents to be maximally effective in clinical trials of sepsis , our animal data suggest that the influence of variables related to both the therapy ( e.g. dose and timing ) and the precipitating infection ( e.g. severity , site and type ) need to be clarified ."
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[] |
[] |
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IntensiveMedizin.70340110.eng.abstr
|
IntensiveMedizin.70340110.eng.abstr
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[] |
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"id": "IntensiveMedizin.70340110.eng.abstr-s2-r12-t6.1-t2.1",
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] |
IntensiveMedizin.70340124.eng.abstr
|
IntensiveMedizin.70340124.eng.abstr
|
[
{
"id": "IntensiveMedizin.70340124.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Shock secondary to sepsis is a serious common disease with a substantial mortality . Coagulation abnormalities , ranging from a rapid fulminant state of disseminated intravascular coagulation ( DIC ) to a slight elevation in the level of fibrin ( ogen ) degradation products , are well recognized in patients with bacterial septicemia . Therefore , the inhibition of the activated coagulation is one of the first therapeutic steps . We investigated 30 intensive care patients with septic disease and comparable signs of abnomalities in coagulation at the beginning . Fifteen patients were treated with 1.5-5 E/kg body weight ( Low dose group ) , the others received 8-15 E/kg ( high dose group ) . Our study demonstrated a significant stronger and faster decline of coagulation parameters - such as d-dimer , TAT and PTF 1 + 2 - in the High dose group without any bleeding disorder . Thus , we support in cases of coagulation disease except fulminant ones the high dose therapy with LMWH as shown above ."
],
"offsets": [
[
0,
1004
]
]
}
] |
[
{
"id": "IntensiveMedizin.70340124.eng.abstr-s1-t1",
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"text": [
"Shock"
],
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0,
5
]
],
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{
"db_name": "UMLS",
"db_id": "C0036974"
}
]
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{
"id": "IntensiveMedizin.70340124.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"secondary"
],
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[
6,
15
]
],
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{
"db_name": "UMLS",
"db_id": "C0027627"
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"db_id": "C0036525"
}
]
},
{
"id": "IntensiveMedizin.70340124.eng.abstr-s1-t3",
"type": "umlsterm",
"text": [
"sepsis"
],
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[
19,
25
]
],
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{
"db_name": "UMLS",
"db_id": "C0243026"
}
]
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"type": "umlsterm",
"text": [
"disease"
],
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[
46,
53
]
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{
"db_name": "UMLS",
"db_id": "C0012634"
}
]
},
{
"id": "IntensiveMedizin.70340124.eng.abstr-s1-t5",
"type": "umlsterm",
"text": [
"mortality"
],
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73,
82
]
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{
"db_name": "UMLS",
"db_id": "C0026566"
},
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}
]
},
{
"id": "IntensiveMedizin.70340124.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"Coagulation"
],
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[
85,
96
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}
]
},
{
"id": "IntensiveMedizin.70340124.eng.abstr-s2-t2",
"type": "umlsterm",
"text": [
"abnormalities"
],
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97,
110
]
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"db_id": "C0000768"
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}
]
},
{
"id": "IntensiveMedizin.70340124.eng.abstr-s2-t3",
"type": "umlsterm",
"text": [
"coagulation"
],
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[
180,
191
]
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{
"db_name": "UMLS",
"db_id": "C0005790"
}
]
},
{
"id": "IntensiveMedizin.70340124.eng.abstr-s2-t4",
"type": "umlsterm",
"text": [
"DIC"
],
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[
194,
197
]
],
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{
"db_name": "UMLS",
"db_id": "C0010927"
},
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}
]
},
{
"id": "IntensiveMedizin.70340124.eng.abstr-s2-t5",
"type": "umlsterm",
"text": [
"fibrin"
],
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238,
244
]
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}
]
},
{
"id": "IntensiveMedizin.70340124.eng.abstr-s2-t6",
"type": "umlsterm",
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"degradation"
],
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[
254,
265
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],
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"db_id": "C0243125"
}
]
},
{
"id": "IntensiveMedizin.70340124.eng.abstr-s2-t7",
"type": "umlsterm",
"text": [
"patients"
],
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300,
308
]
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]
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{
"id": "IntensiveMedizin.70340124.eng.abstr-s2-t8",
"type": "umlsterm",
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"bacterial"
],
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314,
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]
},
{
"id": "IntensiveMedizin.70340124.eng.abstr-s2-t9",
"type": "umlsterm",
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"septicemia"
],
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324,
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"db_id": "C0036690"
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},
{
"id": "IntensiveMedizin.70340124.eng.abstr-s2-t10",
"type": "umlsterm",
"text": [
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],
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},
{
"id": "IntensiveMedizin.70340124.eng.abstr-s3-t1",
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"text": [
"inhibition"
],
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353,
363
]
],
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]
},
{
"id": "IntensiveMedizin.70340124.eng.abstr-s3-t2",
"type": "umlsterm",
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"coagulation"
],
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]
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}
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"id": "IntensiveMedizin.70340124.eng.abstr-s3-t3",
"type": "umlsterm",
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"therapeutic"
],
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413,
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]
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"id": "IntensiveMedizin.70340124.eng.abstr-s4-t1",
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"care"
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}
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{
"id": "IntensiveMedizin.70340124.eng.abstr-s4-t3",
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"disease"
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488,
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}
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{
"id": "IntensiveMedizin.70340124.eng.abstr-s4-t4",
"type": "umlsterm",
"text": [
"signs"
],
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[
511,
516
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"id": "IntensiveMedizin.70340124.eng.abstr-s4-t5",
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"coagulation"
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"faster"
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{
"id": "IntensiveMedizin.70340124.eng.abstr-s6-t2",
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},
{
"id": "IntensiveMedizin.70340124.eng.abstr-s6-t3",
"type": "umlsterm",
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"TAT"
],
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[
809,
812
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],
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"db_id": "C0052128"
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"db_id": "C0039756"
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"type": "umlsterm",
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"disorder"
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"bleeding disorder"
],
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],
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"db_id": "C0005779"
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"id": "IntensiveMedizin.70340124.eng.abstr-s7-t1",
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"coagulation"
],
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914,
925
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"disease"
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926,
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{
"id": "IntensiveMedizin.70340124.eng.abstr-s7-t3",
"type": "umlsterm",
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"therapy"
],
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[
970,
977
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],
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"db_id": "C0087111"
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]
},
{
"id": "IntensiveMedizin.70340124.eng.abstr-s7-t4",
"type": "umlsterm",
"text": [
"LMWH"
],
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[
983,
987
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0019139"
}
]
}
] |
[] |
[] |
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{
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{
"id": "IntensiveMedizin.70340124.eng.abstr-s1-r13-t1.1-t4.1",
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{
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{
"id": "IntensiveMedizin.70340124.eng.abstr-s1-r15-t2.2-t2.1",
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{
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{
"id": "IntensiveMedizin.70340124.eng.abstr-s2-r1-t5.2-t2.1",
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},
{
"id": "IntensiveMedizin.70340124.eng.abstr-s2-r2-t5.2-t8.1",
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"normalized": []
},
{
"id": "IntensiveMedizin.70340124.eng.abstr-s2-r3-t5.1-t10.1",
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{
"id": "IntensiveMedizin.70340124.eng.abstr-s6-r18-t3.1-t5.1",
"type": "affects",
"arg1_id": "IntensiveMedizin.70340124.eng.abstr-s7-t3",
"arg2_id": "IntensiveMedizin.70340124.eng.abstr-s6-t5",
"normalized": []
},
{
"id": "IntensiveMedizin.70340124.eng.abstr-s6-r19-t1.1-t4.1",
"type": "associated_with",
"arg1_id": "IntensiveMedizin.70340124.eng.abstr-s7-t1",
"arg2_id": "IntensiveMedizin.70340124.eng.abstr-s7-t4",
"normalized": []
},
{
"id": "IntensiveMedizin.70340124.eng.abstr-s6-r20-t3.1-t1.1",
"type": "precedes",
"arg1_id": "IntensiveMedizin.70340124.eng.abstr-s7-t3",
"arg2_id": "IntensiveMedizin.70340124.eng.abstr-s7-t1",
"normalized": []
},
{
"id": "IntensiveMedizin.70340124.eng.abstr-s7-r1-t2.1-t3.1",
"type": "associated_with",
"arg1_id": "IntensiveMedizin.70340124.eng.abstr-s7-t2",
"arg2_id": "IntensiveMedizin.70340124.eng.abstr-s7-t3",
"normalized": []
},
{
"id": "IntensiveMedizin.70340124.eng.abstr-s7-r2-t2.1-t1.1",
"type": "associated_with",
"arg1_id": "IntensiveMedizin.70340124.eng.abstr-s7-t2",
"arg2_id": "IntensiveMedizin.70340124.eng.abstr-s7-t1",
"normalized": []
},
{
"id": "IntensiveMedizin.70340124.eng.abstr-s7-r3-t3.1-t2.1",
"type": "associated_with",
"arg1_id": "IntensiveMedizin.70340124.eng.abstr-s7-t3",
"arg2_id": "IntensiveMedizin.70340124.eng.abstr-s7-t2",
"normalized": []
},
{
"id": "IntensiveMedizin.70340124.eng.abstr-s7-r4-t3.1-t2.1",
"type": "affects",
"arg1_id": "IntensiveMedizin.70340124.eng.abstr-s7-t3",
"arg2_id": "IntensiveMedizin.70340124.eng.abstr-s7-t2",
"normalized": []
},
{
"id": "IntensiveMedizin.70340124.eng.abstr-s7-r5-t1.1-t3.1",
"type": "analyzes",
"arg1_id": "IntensiveMedizin.70340124.eng.abstr-s7-t1",
"arg2_id": "IntensiveMedizin.70340124.eng.abstr-s7-t3",
"normalized": []
},
{
"id": "IntensiveMedizin.70340124.eng.abstr-s7-r6-t3.1-t2.1",
"type": "diagnoses",
"arg1_id": "IntensiveMedizin.70340124.eng.abstr-s7-t3",
"arg2_id": "IntensiveMedizin.70340124.eng.abstr-s7-t2",
"normalized": []
},
{
"id": "IntensiveMedizin.70340124.eng.abstr-s7-r7-t1.1-t3.1",
"type": "method_of",
"arg1_id": "IntensiveMedizin.70340124.eng.abstr-s7-t1",
"arg2_id": "IntensiveMedizin.70340124.eng.abstr-s7-t3",
"normalized": []
},
{
"id": "IntensiveMedizin.70340124.eng.abstr-s7-r8-t1.1-t2.1",
"type": "associated_with",
"arg1_id": "IntensiveMedizin.70340124.eng.abstr-s7-t1",
"arg2_id": "IntensiveMedizin.70340124.eng.abstr-s7-t2",
"normalized": []
}
] |
IntensiveMedizin.70340131.eng.abstr
|
IntensiveMedizin.70340131.eng.abstr
|
[
{
"id": "IntensiveMedizin.70340131.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Objektive : To review the prehospital management of patients with suspected acute stroke ."
],
"offsets": [
[
0,
90
]
]
}
] |
[
{
"id": "IntensiveMedizin.70340131.eng.abstr-s1-t1",
"type": "umlsterm",
"text": [
"patients"
],
"offsets": [
[
52,
60
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0030705"
}
]
},
{
"id": "IntensiveMedizin.70340131.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"stroke"
],
"offsets": [
[
82,
88
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0038454"
}
]
},
{
"id": "IntensiveMedizin.70340131.eng.abstr-s1-t3",
"type": "umlsterm",
"text": [
"acute stroke"
],
"offsets": [
[
76,
88
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0751956"
}
]
}
] |
[] |
[] |
[
{
"id": "IntensiveMedizin.70340131.eng.abstr-s1-r1-t3.1-t1.1",
"type": "occurs_in",
"arg1_id": "IntensiveMedizin.70340131.eng.abstr-s1-t3",
"arg2_id": "IntensiveMedizin.70340131.eng.abstr-s1-t1",
"normalized": []
},
{
"id": "IntensiveMedizin.70340131.eng.abstr-s1-r2-t2.1-t1.1",
"type": "occurs_in",
"arg1_id": "IntensiveMedizin.70340131.eng.abstr-s1-t2",
"arg2_id": "IntensiveMedizin.70340131.eng.abstr-s1-t1",
"normalized": []
}
] |
IntensiveMedizin.70340140.eng.abstr
|
IntensiveMedizin.70340140.eng.abstr
|
[
{
"id": "IntensiveMedizin.70340140.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Although malignant pericardial and pleural effusions are a common complication through the course of malignancies , it is rarely the initial manifestation of a mali-gnant disease ."
],
"offsets": [
[
0,
180
]
]
}
] |
[
{
"id": "IntensiveMedizin.70340140.eng.abstr-s1-t1",
"type": "umlsterm",
"text": [
"malignant"
],
"offsets": [
[
9,
18
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0006826"
}
]
},
{
"id": "IntensiveMedizin.70340140.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"pleural"
],
"offsets": [
[
35,
42
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0032226"
}
]
},
{
"id": "IntensiveMedizin.70340140.eng.abstr-s1-t3",
"type": "umlsterm",
"text": [
"complication"
],
"offsets": [
[
66,
78
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0009566"
}
]
},
{
"id": "IntensiveMedizin.70340140.eng.abstr-s1-t4",
"type": "umlsterm",
"text": [
"malignancies"
],
"offsets": [
[
101,
113
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0006826"
}
]
},
{
"id": "IntensiveMedizin.70340140.eng.abstr-s1-t5",
"type": "umlsterm",
"text": [
"disease"
],
"offsets": [
[
171,
178
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0012634"
}
]
},
{
"id": "IntensiveMedizin.70340140.eng.abstr-s1-t6",
"type": "umlsterm",
"text": [
"pleural effusions"
],
"offsets": [
[
35,
52
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0032227"
}
]
}
] |
[] |
[] |
[
{
"id": "IntensiveMedizin.70340140.eng.abstr-s1-r1-t6.1-t1.1",
"type": "associated_with",
"arg1_id": "IntensiveMedizin.70340140.eng.abstr-s1-t6",
"arg2_id": "IntensiveMedizin.70340140.eng.abstr-s1-t1",
"normalized": []
},
{
"id": "IntensiveMedizin.70340140.eng.abstr-s1-r2-t6.1-t4.1",
"type": "associated_with",
"arg1_id": "IntensiveMedizin.70340140.eng.abstr-s1-t6",
"arg2_id": "IntensiveMedizin.70340140.eng.abstr-s1-t4",
"normalized": []
},
{
"id": "IntensiveMedizin.70340140.eng.abstr-s1-r3-t6.1-t3.1",
"type": "associated_with",
"arg1_id": "IntensiveMedizin.70340140.eng.abstr-s1-t6",
"arg2_id": "IntensiveMedizin.70340140.eng.abstr-s1-t3",
"normalized": []
},
{
"id": "IntensiveMedizin.70340140.eng.abstr-s1-r4-t1.1-t4.1",
"type": "degree_of",
"arg1_id": "IntensiveMedizin.70340140.eng.abstr-s1-t1",
"arg2_id": "IntensiveMedizin.70340140.eng.abstr-s1-t4",
"normalized": []
},
{
"id": "IntensiveMedizin.70340140.eng.abstr-s1-r5-t3.1-t6.1",
"type": "associated_with",
"arg1_id": "IntensiveMedizin.70340140.eng.abstr-s1-t3",
"arg2_id": "IntensiveMedizin.70340140.eng.abstr-s1-t6",
"normalized": []
},
{
"id": "IntensiveMedizin.70340140.eng.abstr-s1-r6-t1.1-t3.1",
"type": "degree_of",
"arg1_id": "IntensiveMedizin.70340140.eng.abstr-s1-t1",
"arg2_id": "IntensiveMedizin.70340140.eng.abstr-s1-t3",
"normalized": []
},
{
"id": "IntensiveMedizin.70340140.eng.abstr-s1-r7-t1.1-t6.1",
"type": "associated_with",
"arg1_id": "IntensiveMedizin.70340140.eng.abstr-s1-t1",
"arg2_id": "IntensiveMedizin.70340140.eng.abstr-s1-t6",
"normalized": []
},
{
"id": "IntensiveMedizin.70340140.eng.abstr-s1-r8-t3.1-t4.1",
"type": "degree_of",
"arg1_id": "IntensiveMedizin.70340140.eng.abstr-s1-t3",
"arg2_id": "IntensiveMedizin.70340140.eng.abstr-s1-t4",
"normalized": []
},
{
"id": "IntensiveMedizin.70340140.eng.abstr-s1-r9-t3.1-t1.1",
"type": "degree_of",
"arg1_id": "IntensiveMedizin.70340140.eng.abstr-s1-t3",
"arg2_id": "IntensiveMedizin.70340140.eng.abstr-s1-t1",
"normalized": []
}
] |
IntensiveMedizin.70340145.eng.abstr
|
IntensiveMedizin.70340145.eng.abstr
|
[
{
"id": "IntensiveMedizin.70340145.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Since there are clear concerns about anesthesia in emergency medicine , physicians have been interviewed concerning its application in a prehospital setting . Forty-four percent of emergency doctors were anesthesists with several years experience in emergency medicine and anesthesia . In 61% of cases anesthesia was performed in traumatic patients where babiturates were used in 55% . While Ketamine is used in the hospital in only 5% , it is used in 16% in a prelinical setting . Fifty-three percent of emergency doctors do use muscle relaxation and 47% not at all . If it was used , suxamethonium was the most used muscle relaxant ( 39% ) . Advantages and disadvantages of alternative narcotics are discussed with special focus on its usefulness in a preclinical setting . It is concluded that anesthesia in emergency medicine needs to be intensified in the training of emergency doctors ."
],
"offsets": [
[
0,
892
]
]
}
] |
[
{
"id": "IntensiveMedizin.70340145.eng.abstr-s1-t1",
"type": "umlsterm",
"text": [
"anesthesia"
],
"offsets": [
[
37,
47
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0002903"
}
]
},
{
"id": "IntensiveMedizin.70340145.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"emergency"
],
"offsets": [
[
51,
60
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0013956"
}
]
},
{
"id": "IntensiveMedizin.70340145.eng.abstr-s1-t3",
"type": "umlsterm",
"text": [
"medicine"
],
"offsets": [
[
61,
69
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0025118"
},
{
"db_name": "UMLS",
"db_id": "C0013227"
}
]
},
{
"id": "IntensiveMedizin.70340145.eng.abstr-s1-t4",
"type": "umlsterm",
"text": [
"physicians"
],
"offsets": [
[
72,
82
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0031831"
}
]
},
{
"id": "IntensiveMedizin.70340145.eng.abstr-s1-t5",
"type": "umlsterm",
"text": [
"emergency medicine"
],
"offsets": [
[
51,
69
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0013964"
}
]
},
{
"id": "IntensiveMedizin.70340145.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"emergency"
],
"offsets": [
[
181,
190
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0013956"
}
]
},
{
"id": "IntensiveMedizin.70340145.eng.abstr-s2-t2",
"type": "umlsterm",
"text": [
"doctors"
],
"offsets": [
[
191,
198
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0031831"
}
]
},
{
"id": "IntensiveMedizin.70340145.eng.abstr-s2-t3",
"type": "umlsterm",
"text": [
"emergency"
],
"offsets": [
[
250,
259
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0013956"
}
]
},
{
"id": "IntensiveMedizin.70340145.eng.abstr-s2-t4",
"type": "umlsterm",
"text": [
"medicine"
],
"offsets": [
[
260,
268
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0025118"
},
{
"db_name": "UMLS",
"db_id": "C0013227"
}
]
},
{
"id": "IntensiveMedizin.70340145.eng.abstr-s2-t5",
"type": "umlsterm",
"text": [
"anesthesia"
],
"offsets": [
[
273,
283
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0002903"
}
]
},
{
"id": "IntensiveMedizin.70340145.eng.abstr-s2-t6",
"type": "umlsterm",
"text": [
"emergency medicine"
],
"offsets": [
[
250,
268
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0013964"
}
]
},
{
"id": "IntensiveMedizin.70340145.eng.abstr-s3-t1",
"type": "umlsterm",
"text": [
"anesthesia"
],
"offsets": [
[
302,
312
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0002903"
}
]
},
{
"id": "IntensiveMedizin.70340145.eng.abstr-s3-t2",
"type": "umlsterm",
"text": [
"patients"
],
"offsets": [
[
340,
348
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0030705"
}
]
},
{
"id": "IntensiveMedizin.70340145.eng.abstr-s4-t1",
"type": "umlsterm",
"text": [
"Ketamine"
],
"offsets": [
[
392,
400
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0022614"
}
]
},
{
"id": "IntensiveMedizin.70340145.eng.abstr-s4-t2",
"type": "umlsterm",
"text": [
"hospital"
],
"offsets": [
[
416,
424
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0019994"
}
]
},
{
"id": "IntensiveMedizin.70340145.eng.abstr-s5-t1",
"type": "umlsterm",
"text": [
"emergency"
],
"offsets": [
[
505,
514
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0013956"
}
]
},
{
"id": "IntensiveMedizin.70340145.eng.abstr-s5-t2",
"type": "umlsterm",
"text": [
"doctors"
],
"offsets": [
[
515,
522
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0031831"
}
]
},
{
"id": "IntensiveMedizin.70340145.eng.abstr-s5-t3",
"type": "umlsterm",
"text": [
"use"
],
"offsets": [
[
526,
529
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0042153"
}
]
},
{
"id": "IntensiveMedizin.70340145.eng.abstr-s5-t4",
"type": "umlsterm",
"text": [
"muscle"
],
"offsets": [
[
530,
536
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0026845"
}
]
},
{
"id": "IntensiveMedizin.70340145.eng.abstr-s5-t5",
"type": "umlsterm",
"text": [
"relaxation"
],
"offsets": [
[
537,
547
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0035028"
}
]
},
{
"id": "IntensiveMedizin.70340145.eng.abstr-s5-t6",
"type": "umlsterm",
"text": [
"muscle relaxation"
],
"offsets": [
[
530,
547
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0026827"
},
{
"db_name": "UMLS",
"db_id": "C0026836"
}
]
},
{
"id": "IntensiveMedizin.70340145.eng.abstr-s6-t1",
"type": "umlsterm",
"text": [
"suxamethonium"
],
"offsets": [
[
586,
599
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0038627"
}
]
},
{
"id": "IntensiveMedizin.70340145.eng.abstr-s6-t2",
"type": "umlsterm",
"text": [
"muscle"
],
"offsets": [
[
618,
624
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0026845"
}
]
},
{
"id": "IntensiveMedizin.70340145.eng.abstr-s7-t1",
"type": "umlsterm",
"text": [
"narcotics"
],
"offsets": [
[
688,
697
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0027415"
}
]
},
{
"id": "IntensiveMedizin.70340145.eng.abstr-s8-t1",
"type": "umlsterm",
"text": [
"anesthesia"
],
"offsets": [
[
797,
807
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0002903"
}
]
},
{
"id": "IntensiveMedizin.70340145.eng.abstr-s8-t2",
"type": "umlsterm",
"text": [
"emergency"
],
"offsets": [
[
811,
820
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0013956"
}
]
},
{
"id": "IntensiveMedizin.70340145.eng.abstr-s8-t3",
"type": "umlsterm",
"text": [
"medicine"
],
"offsets": [
[
821,
829
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0025118"
},
{
"db_name": "UMLS",
"db_id": "C0013227"
}
]
},
{
"id": "IntensiveMedizin.70340145.eng.abstr-s8-t4",
"type": "umlsterm",
"text": [
"training"
],
"offsets": [
[
861,
869
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0040607"
},
{
"db_name": "UMLS",
"db_id": "C0220931"
}
]
},
{
"id": "IntensiveMedizin.70340145.eng.abstr-s8-t5",
"type": "umlsterm",
"text": [
"emergency"
],
"offsets": [
[
873,
882
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0013956"
}
]
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IntensiveMedizin.70340153.eng.abstr
|
IntensiveMedizin.70340153.eng.abstr
|
[
{
"id": "IntensiveMedizin.70340153.eng.abstr-passage-0",
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"text": [
"Bacterial respiration filters are able to prevent the contamination of anesthetic equipment in inhalation anesthesia . In consequence , no further changes of tubes are required for each patient , and the tubes can be changed daily or at even longer intervals . As a result of an decreased frequency of reprocessing and less damage of the tubing material an economic advantage is obvious . There are no studies indicating a reduction of frequency of pneumonia during mechanical ventilation by bacterial respiration filters . Thus the use of these filters is not recommended in intensive care units . Furthermore , no changes of tubes are recommended every 48 h ; they can be changed at least once a week without the use of bacterial respiration filters . This is possible without additional risk for patients to acquire pneumonia and also leads to enormous cost reduction ."
],
"offsets": [
[
0,
872
]
]
}
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{
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365
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{
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IntensiveMedizin.70340198.eng.abstr
|
IntensiveMedizin.70340198.eng.abstr
|
[
{
"id": "IntensiveMedizin.70340198.eng.abstr-passage-0",
"type": "abstract",
"text": [
"During the years 1993-1995 several studies have been published on topics of clinical toxicology . Those of clinical interest are being discussed : in general poisoning therapy there is an outspoken tendency to use activated charcoal therapy and avoid gastric lavage and emesis . Extracorporal treatments like continuous arteriovenous hemoperfusion ( CAVHP ) are effective with poisoning of phenobarbital and theophylline . As a proven indication for poisoning with cyanide hydroxycobalamin is meant to be an effective antidote . The benefit of a N-acetylcysteine antidote therapy can be optimized by a prolonged duration of treatment . By prolonging the start dosage to 60 minutes side-effects are reduced . The serum level taken after 4 h of paracetamol ingestion must be interpreted carefully . When seriously poisoned by digitalis antidote and pacemaker therapy are indicated . A poisoning with zolpidem is similar to benzodiacepines and tricyclic antidepressive drug overdosage goes together with the highest mortality . Poisoning with ibuprofen can endanger life ."
],
"offsets": [
[
0,
1069
]
]
}
] |
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"id": "IntensiveMedizin.70340198.eng.abstr-s1-t1",
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"toxicology"
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85,
95
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{
"id": "IntensiveMedizin.70340198.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"poisoning"
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158,
167
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},
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"id": "IntensiveMedizin.70340198.eng.abstr-s2-t2",
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"text": [
"therapy"
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168,
175
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{
"id": "IntensiveMedizin.70340198.eng.abstr-s2-t3",
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"charcoal"
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224,
232
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{
"id": "IntensiveMedizin.70340198.eng.abstr-s2-t5",
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"lavage"
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{
"id": "IntensiveMedizin.70340198.eng.abstr-s2-t6",
"type": "umlsterm",
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"emesis"
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276
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}
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{
"id": "IntensiveMedizin.70340198.eng.abstr-s2-t7",
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"text": [
"activated charcoal"
],
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[
214,
232
]
],
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"db_id": "C0001275"
}
]
},
{
"id": "IntensiveMedizin.70340198.eng.abstr-s2-t8",
"type": "umlsterm",
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"gastric lavage"
],
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[
251,
265
]
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"db_id": "C0017134"
}
]
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{
"id": "IntensiveMedizin.70340198.eng.abstr-s3-t1",
"type": "umlsterm",
"text": [
"treatments"
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303
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}
]
},
{
"id": "IntensiveMedizin.70340198.eng.abstr-s3-t2",
"type": "umlsterm",
"text": [
"hemoperfusion"
],
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334,
347
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}
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"id": "IntensiveMedizin.70340198.eng.abstr-s3-t3",
"type": "umlsterm",
"text": [
"poisoning"
],
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386
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{
"id": "IntensiveMedizin.70340198.eng.abstr-s3-t4",
"type": "umlsterm",
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"phenobarbital"
],
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390,
403
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"id": "IntensiveMedizin.70340198.eng.abstr-s3-t5",
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"text": [
"theophylline"
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420
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"id": "IntensiveMedizin.70340198.eng.abstr-s4-t1",
"type": "umlsterm",
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"proven"
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428,
434
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{
"id": "IntensiveMedizin.70340198.eng.abstr-s4-t3",
"type": "umlsterm",
"text": [
"cyanide"
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"id": "IntensiveMedizin.70340198.eng.abstr-s4-t4",
"type": "umlsterm",
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"hydroxycobalamin"
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"id": "IntensiveMedizin.70340198.eng.abstr-s4-t5",
"type": "umlsterm",
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"antidote"
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"id": "IntensiveMedizin.70340198.eng.abstr-s5-t1",
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"text": [
"N-acetylcysteine"
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"db_id": "C0001047"
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"id": "IntensiveMedizin.70340198.eng.abstr-s5-t2",
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"antidote"
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"id": "IntensiveMedizin.70340198.eng.abstr-s9-t2",
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"zolpidem"
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"mortality"
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{
"id": "IntensiveMedizin.70340198.eng.abstr-s10-t2",
"type": "umlsterm",
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"db_id": "C0376558"
}
]
}
] |
[] |
[] |
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] |
IntensiveMedizin.70340206.eng.abstr
|
IntensiveMedizin.70340206.eng.abstr
|
[
{
"id": "IntensiveMedizin.70340206.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Paracetamol ( Acetaminophen , N-acetyl-para-aminophenol ) ingestion is the commonest reported cause of intensional drug overdose in both the United States and the United Kingdom but despite the large number of overdose cases severe complications occur in a relatively small percentage . Severe hepatotoxicity can be anticipated in any individual who has a serum paracetamol level above the standard treatment line or who has ingested more than the minimum hepatotoxic dose of 125 mg/kg ( 7.5 g or fifteen 500 mg tablets in a 60 kg individual ) . In these cases treatment with N-acetylcysteine should be commenced as soon as possible . In addition , every patient where either the size or timing of the overdose is unclear should receive a full course of N-acetylcysteine regardless of their serum levels . In all cases where N-acetylcysteine has been started it should be continued if there is evidence of worsening hepatic function . At the earliest sign of severe hepatotoxicity a specialist liver unit should be contacted to ensure optimal management or immediate transfer if there is a likelihood that acute liver failure may develop . Liver transplantation in the most severe cases has significantly improved the outcome of a previously unsalvageable group of patients but a further improvement in outcome can only be achieved by closer cooperation between referring hospitals and specialist liver units ."
],
"offsets": [
[
0,
1410
]
]
}
] |
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IntensiveMedizin.70340220.eng.abstr
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IntensiveMedizin.70340220.eng.abstr
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"The comparison of prediction of mortality and sepsis by different score systems was the objective of this retrospective study in 51 patients . Specific scores for burned patients - \" Abbreviated Burn Severity Index \" ( ABSI ) and the \" Baltimore Sepsis Scale \" ( BSS ) were compared with the general intensive score systems : \" Mortality Prediction Model \" ( MPM II ) , \" Simplified Acute Physiology Score \" ( SAPS II ) , APACHE II ( ApII ) , \" Hannover Intensive Score \" ( HIS ) and the sepsis score developed by Elebute and Stoner ( ES ) . On days 1 and 3 the true-positive ratio ( sensitivity ) was plotted against false-positive ratio ( 1-specifity ) for each score . The area under the curve ( max . 1 ; min . 0.5 ) correlates with the quality of the score system . We also tested the discrimination of septic and nonseptic patients by using the different scores ."
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[] |
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IntensiveMedizin.70340227.eng.abstr
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IntensiveMedizin.70340227.eng.abstr
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IntensiveMedizin.70340230.eng.abstr
|
IntensiveMedizin.70340230.eng.abstr
|
[
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"id": "IntensiveMedizin.70340230.eng.abstr-passage-0",
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"text": [
"Efforts of control and improve quality of structure , processes , and outcome should be considered as components of an overall quality management in intensive care . To measure quality , standards are useful in the field of structure quality only , because of their high level of obligation , often mandated by legislation . Conferences , continuing education , and guidelines are the instruments to measure and improve quality of processes and outcome . Outcome is determined by survival rate and quality of life of surviving patients . Outcome quality in individual units my be compared with the predicted risk of mortality ( standardized mortality index ) , calculated from score systems . Standards and guidelines should be further developed and methods of outcome management be improved ."
],
"offsets": [
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0,
793
]
]
}
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[] |
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] |
IntensiveMedizin.70340237.eng.abstr
|
IntensiveMedizin.70340237.eng.abstr
|
[
{
"id": "IntensiveMedizin.70340237.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Patients presenting to the emergency department with acute abdominal pain represent a substantial challenge to the physician . To differentiate among the various causes of abdominal pain , several key features of the history must be explored in depth ( onset of pain , location of pain , intensity of pain , particular pattern of pain referral ) and a complete physical examination should be meticulously executed . A number of metabolic or primarily medical conditions may cause abdominal pain , and great caution must be maintained if these are to be recognized ( pulmonary embolus , myocardial infarction , diabetic ketoacidosis , etc. ) . There exists several groups of patients in whom the usual symptoms and expected findings are not apparent ; children , the elderly , the chronically debilitated , the depressed , and those patients chronically exposed to steroids are examples . Laboratory findings and imaging techniques should be carefully evaluated because they may provide the only clue to a diagnosis not previously considered . A useful guide to the management of patients with abdominal pain in the emergency room concludes this brief review ."
],
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[] |
[] |
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IntensiveMedizin.70340243.eng.abstr
|
IntensiveMedizin.70340243.eng.abstr
|
[
{
"id": "IntensiveMedizin.70340243.eng.abstr-passage-0",
"type": "abstract",
"text": [
"In the last few years two placebo controlled studies ( European Cooperative Acute Stroke Study and National Institute of Neurological Disorders and Stroke Study ) analyzed the effect of systemic thrombolytic therapy with recombinant tissue plasminogen activator ( rt-PA ) in acute hemispheric stroke . Both studies showed a positive longtime effect for the rt-PA treated patients . The number of symptomatic intracerebral hemorrhage was higher in the rt-PA treated groups . The results determine possible clinical or neuroradiological predictors of intracerebral hemorrhage associated with rt-PA therapy ."
],
"offsets": [
[
0,
605
]
]
}
] |
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] |
IntensiveMedizin.70340255.eng.abstr
|
IntensiveMedizin.70340255.eng.abstr
|
[
{
"id": "IntensiveMedizin.70340255.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Evoked potentials ( EP ) are a valuable tool when assessment of neurocritical care patients is impaired by loss of consciousness and lack of co-operation . Different modalities of short latency EP can be applied to evaluate sensory , auditory and visual systems . In this review we discuss EP studies in patients with thrombosis of basilar artery , space occupying cerebellar infarction and supratentorial mass lesions of different aetiology ."
],
"offsets": [
[
0,
443
]
]
}
] |
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{
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},
{
"id": "IntensiveMedizin.70340255.eng.abstr-s1-t6",
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{
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{
"id": "IntensiveMedizin.70340255.eng.abstr-s3-t2",
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"id": "IntensiveMedizin.70340255.eng.abstr-s3-t3",
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},
{
"id": "IntensiveMedizin.70340255.eng.abstr-s3-t4",
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"id": "IntensiveMedizin.70340255.eng.abstr-s3-t5",
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"id": "IntensiveMedizin.70340255.eng.abstr-s3-t6",
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346
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"normalized": [
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"db_name": "UMLS",
"db_id": "C0004811"
}
]
}
] |
[] |
[] |
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IntensiveMedizin.70340279.eng.abstr
|
IntensiveMedizin.70340279.eng.abstr
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{
"id": "IntensiveMedizin.70340279.eng.abstr-passage-0",
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"Intoxications with betablockers are common cases in emergency and intensive care medicine . Main symptoms are bradycardia , low blood pressure and neurological symptoms . The present study is based upon 244 intoxications with betablockers between 1986 and 1996. During childhood ( age 1 - 5 years ) an accidential intake of 1-2 tablets of a betablocker ( max . 320 mg ) does not cause any severe symptoms , hence the necessity of emesis and gastric lavage have to be considered cautiously . There is no correlation between ingested dose of the betablocker and expected symptoms , especially at higher doses when taken in a suicidal attempt . It is necessary to take into account preexisting diseases for examination of the expected grade of intoxication . The present study cannot give definite results about pharmacological properties and toxic effect of several betablockers . Considering the results of this study and from careful examination of the literature early detoxication and consequent clinical monitoring is recommendable . In case of clinical symptoms , as described above , drugs like dopamin and glucagon could be applied ."
],
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0,
1139
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[] |
[] |
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IntensiveMedizin.70340286.eng.abstr
|
IntensiveMedizin.70340286.eng.abstr
|
[
{
"id": "IntensiveMedizin.70340286.eng.abstr-passage-0",
"type": "abstract",
"text": [
"A penetrating chest injury is often associated with respiratory insufficiency due to primary hindrance of gas exchange or the respiratory mechanical function . Additional cardiocirculatory disturbances caused by bleeding or injury of the heart are often life-threatening . The preclinical treatment should aim to optimize ventilation and oxygenation , to recognize and treat tension pneumothorax and pericardial tamponade and also to transport the patient to a hospital where cardiac surgery is feasible . A penetrating injury of the left anterior hemithorax is suggestive of a direct injury to the heart . If the function of the circulatory system is unstable , then the patient must be sternotomized immediately . If the function of the circulatory system is stable only basic diagnostics are required . If the patient is becoming more unstable or in case of any doubt , an operative exploration should be performed . We describe a 41-year old male patient who sustained left thoracic trauma after a stab injury . Dissection of the left internal mammary artery and the left lung led to massive hemothorax . The patient was initially transported to a hospital with a cardiac surgery department and was sternotomized within 30 min of arrival ."
],
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1243
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]
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IntensiveMedizin.70340291.eng.abstr
|
IntensiveMedizin.70340291.eng.abstr
|
[
{
"id": "IntensiveMedizin.70340291.eng.abstr-passage-0",
"type": "abstract",
"text": [
"A 68-year-old patient with dyspnea since 5 days from pulmonary embolism documented by perfusion scintigraphy underwent examination with ultrasound before thrombolytic therapy . US showed a transit-thrombus in the right atrium . Because of threat to life a thrombolytic therapy was given with 9 million IE of streptokinase over 6 h ( UHSK ) and additional therapy with heparin . After three courses of UHSK the transit-thrombus and the thrombosis of the leg had nearly completely resolved . This mode of therapy is an interesting alternative in treatment for pulmonary embolism and transit-thrombus of the right heart ."
],
"offsets": [
[
0,
618
]
]
}
] |
[
{
"id": "IntensiveMedizin.70340291.eng.abstr-s1-t1",
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"patient"
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21
]
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"db_id": "C0030705"
}
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{
"id": "IntensiveMedizin.70340291.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"dyspnea"
],
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[
27,
34
]
],
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"db_id": "C0013404"
}
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},
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"id": "IntensiveMedizin.70340291.eng.abstr-s1-t3",
"type": "umlsterm",
"text": [
"embolism"
],
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63,
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]
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}
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},
{
"id": "IntensiveMedizin.70340291.eng.abstr-s1-t4",
"type": "umlsterm",
"text": [
"perfusion"
],
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[
86,
95
]
],
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{
"db_name": "UMLS",
"db_id": "C0031001"
}
]
},
{
"id": "IntensiveMedizin.70340291.eng.abstr-s1-t5",
"type": "umlsterm",
"text": [
"scintigraphy"
],
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[
96,
108
]
],
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"db_id": "C0034606"
}
]
},
{
"id": "IntensiveMedizin.70340291.eng.abstr-s1-t6",
"type": "umlsterm",
"text": [
"ultrasound"
],
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[
136,
146
]
],
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"db_id": "C0220934"
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"db_id": "C0041618"
},
{
"db_name": "UMLS",
"db_id": "C0041621"
}
]
},
{
"id": "IntensiveMedizin.70340291.eng.abstr-s1-t7",
"type": "umlsterm",
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"thrombolytic"
],
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[
154,
166
]
],
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"db_id": "C0016018"
}
]
},
{
"id": "IntensiveMedizin.70340291.eng.abstr-s1-t8",
"type": "umlsterm",
"text": [
"therapy"
],
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[
167,
174
]
],
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"db_id": "C0087111"
},
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"db_id": "C0039798"
}
]
},
{
"id": "IntensiveMedizin.70340291.eng.abstr-s1-t9",
"type": "umlsterm",
"text": [
"pulmonary embolism"
],
"offsets": [
[
53,
71
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0034065"
}
]
},
{
"id": "IntensiveMedizin.70340291.eng.abstr-s1-t10",
"type": "umlsterm",
"text": [
"thrombolytic therapy"
],
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[
154,
174
]
],
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"db_id": "C0040044"
}
]
},
{
"id": "IntensiveMedizin.70340291.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"transit-thrombus"
],
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[
189,
205
]
],
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"db_id": "C0087086"
}
]
},
{
"id": "IntensiveMedizin.70340291.eng.abstr-s2-t2",
"type": "umlsterm",
"text": [
"right"
],
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[
213,
218
]
],
"normalized": [
{
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"db_id": "C0035621"
}
]
},
{
"id": "IntensiveMedizin.70340291.eng.abstr-s2-t3",
"type": "umlsterm",
"text": [
"atrium"
],
"offsets": [
[
219,
225
]
],
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"db_id": "C0376784"
},
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"db_id": "C0018792"
}
]
},
{
"id": "IntensiveMedizin.70340291.eng.abstr-s2-t4",
"type": "umlsterm",
"text": [
"right atrium"
],
"offsets": [
[
213,
225
]
],
"normalized": [
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"db_id": "C0225844"
}
]
},
{
"id": "IntensiveMedizin.70340291.eng.abstr-s3-t1",
"type": "umlsterm",
"text": [
"life"
],
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249,
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]
],
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},
{
"id": "IntensiveMedizin.70340291.eng.abstr-s3-t2",
"type": "umlsterm",
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],
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256,
268
]
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},
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"id": "IntensiveMedizin.70340291.eng.abstr-s3-t3",
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},
{
"id": "IntensiveMedizin.70340291.eng.abstr-s3-t4",
"type": "umlsterm",
"text": [
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],
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"db_id": "C0038418"
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"id": "IntensiveMedizin.70340291.eng.abstr-s3-t6",
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"heparin"
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"id": "IntensiveMedizin.70340291.eng.abstr-s3-t7",
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{
"id": "IntensiveMedizin.70340291.eng.abstr-s4-t1",
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],
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"db_id": "C0034065"
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}
] |
[] |
[] |
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] |
IntensiveMedizin.70340307.eng.abstr
|
IntensiveMedizin.70340307.eng.abstr
|
[
{
"id": "IntensiveMedizin.70340307.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Several studies have shown that HME-filters are not able to prevent the contamination of anesthetic equipment in inhalation anesthesia under experimental conditions . No study could show so far that the frequency of postoperative pneumonia can be decreased with HME-filters . Thus the use of HME-filters in inhalation anesthesia cannot be recommended at present . In addition there are no studies indicating a reduction of frequency of pneumonia during mechanical ventilation by HME-filters in intensive care units . Tubes of mechanical ventilated patients can be changed once a week without the use of HME-filters . This is possible without additional risk for patients to acquire pneumonia . From an economical point of view heat and moisture exchange by cascade is superior to HME-filters . In consequence , for hygienic reasons there is no rational for the use of HME-filters in intensive care units ."
],
"offsets": [
[
0,
905
]
]
}
] |
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[] |
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] |
IntensiveMedizin.70340312.eng.abstr
|
IntensiveMedizin.70340312.eng.abstr
|
[
{
"id": "IntensiveMedizin.70340312.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Electronic monitoring encloses the DP-assisted observation of leads , the recording , processing and storage of vital functional data . The clinical requirements for the practical monitoring and applicable methods are being briefly described as well as the basics of data processing . A general concept is described only for basic monitoring . It should include the ECG , heart rate , transcutaneous oxygen saturation ( pulse oximetry ) , respiratory rate , body temperature and non-invasive blood pressure control . The direct control of the arterial pressure should be employed generously . Other monitoring methods are being reserved for special indications , pulmonalis catheters and the tonometry of the gastric fluid can be employed for a relatively short period and are therefore not always described under the term of continuous monitoring ."
],
"offsets": [
[
0,
849
]
]
}
] |
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"id": "IntensiveMedizin.70340312.eng.abstr-s6-r6-t1.2-t4.1",
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] |
IntensiveMedizin.70340329.eng.abstr
|
IntensiveMedizin.70340329.eng.abstr
|
[
{
"id": "IntensiveMedizin.70340329.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Longstanding diagnostic and therapeutic management concepts in critical care medicine have to be reevaluated in the context of quality control . The following presentation of the \" Lidocaine-Story \" could serve as an example : in the seventies and eighties Lidocaine was prophylactically administered to patients with acute coronary heart disease ( CHD ) , when so-called \" warning arrhythmias \" ( precursors of life threatening rhythm disturbances ) appeared ; the value of such a prophylaxis remained uncertain although in worldwide use . Later , the measurement of the lidocaine concentration in plasma and the forecasting of individualized dosage became available . However , the significance of this form of managing ventricular arrhythmias was difficult to prove , especially , because of the decrease in the frequency of life threatening arrhythmias during the years of up-coming reperfusion therapies . In a controlled study we intended to further clarify : 1 ) the question of the significance of \" warning arrhythmias \" and 2 ) the value of the concept of lidocaine prophylaxis in the future , including the expending form of differentiated arrhythmia monitoring ."
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0,
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"id": "IntensiveMedizin.70340329.eng.abstr-s2-t4",
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"id": "IntensiveMedizin.70340329.eng.abstr-s2-t9",
"type": "umlsterm",
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"id": "IntensiveMedizin.70340329.eng.abstr-s2-t10",
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"id": "IntensiveMedizin.70340329.eng.abstr-s2-t12",
"type": "umlsterm",
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"id": "IntensiveMedizin.70340329.eng.abstr-s3-t2",
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"lidocaine"
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"id": "IntensiveMedizin.70340329.eng.abstr-s3-t3",
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"concentration"
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"id": "IntensiveMedizin.70340329.eng.abstr-s3-t4",
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"plasma"
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"id": "IntensiveMedizin.70340329.eng.abstr-s4-t1",
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"id": "IntensiveMedizin.70340329.eng.abstr-s4-t6",
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"id": "IntensiveMedizin.70340329.eng.abstr-s4-t7",
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{
"id": "IntensiveMedizin.70340329.eng.abstr-s5-t3",
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"id": "IntensiveMedizin.70340329.eng.abstr-s5-t7",
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"db_name": "UMLS",
"db_id": "C0003811"
}
]
}
] |
[] |
[] |
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"arg2_id": "IntensiveMedizin.70340329.eng.abstr-s5-t4",
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{
"id": "IntensiveMedizin.70340329.eng.abstr-s2-r11-t4.1-t2.1",
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"id": "IntensiveMedizin.70340329.eng.abstr-s2-r15-t1.1-t8.1",
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"id": "IntensiveMedizin.70340329.eng.abstr-s2-r17-t4.1-t6.1",
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] |
IntensiveMedizin.70340333.eng.abstr
|
IntensiveMedizin.70340333.eng.abstr
|
[
{
"id": "IntensiveMedizin.70340333.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Damage/dysfunctioning of the heart forms part of the multiple organ dysfunction syndrome ( MODS ) in sepsis and SIRS . This acute septic cardiomyopathy is often underestimated in degree and relevance , although about 10% of all sepsis fatalities are due to intractable heart failure . This potentially reversible cardiomyopathy is characterized by a considerable pump failure , not primarily ischemic , with coronary blood flow being normal or even enhanced ; the left and right ventricle is enlarged as a consequence of an increased ventricular compliance . Damage of the heart can further be aggravated in case of additional right ventricular impairment due to pulmonary hypertension in ARDS . SIRS-cardiomyopathy in non-infectious MODS has common traits with acute septic cardiomyopathy . The pathogenesis of heart disease in sepsis and SIRS is multifactorial , the endotoxin/TNF/NO/ cGMP-cascade representing a main negative inotropic axis . Therapy of acute septic cardiomyopathy and SIRS-cardiomyopathy at present is still mainly symptomatic ( volume substitution , inotropic/vasoactive agents ) ; causal therapeutic principles are , however , put to test in the context of a comprehensive concept of causal sepsis treatment ."
],
"offsets": [
[
0,
1232
]
]
}
] |
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IntensiveMedizin.70340352.eng.abstr
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IntensiveMedizin.70340370.eng.abstr
|
IntensiveMedizin.70340370.eng.abstr
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"The vasodilatory prostanoids PGE1 and PGI2 possess strong vasodilatory potency in the pulmonary circulation . Their application is , however , limited by the lack of pulmonary and intrapulmonary selectivity . By use of chronic ambulatory PGI2-infusion, patients with primary pulmonary hypertension ( PPH ) may be bridged for ( heart- ) lung transplantation . In patients with adult respiratory distress syndrome ( ARDS ) , PGE1 and PGI2 lower the pulmonary vascular resistance , but may also decrease the systemic pressure ( limited pulmonary selectivity ) and increase ventilation-perfusion-mismatch , accompanied by an impairment of gas exchange ( limited intrapulmonary selectivity ) . Application of PGI2 via the transbronchial route ( aerosol ) may achieve pulmonary and intrapulmonary selectivity with an efficacy profile comparable to that of the selective pulmonary vasodilator nitric oxide ( NO ) . Repetitive aerosol application of the stable PGI2 analogue iloprost is under consideration for long-term treatment of patients with severe pulmonary hypertension such as primary pulmonary hypertension ."
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[] |
[] |
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] |
IntensiveMedizin.70340381.eng.abstr
|
IntensiveMedizin.70340381.eng.abstr
|
[
{
"id": "IntensiveMedizin.70340381.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Procalcitonin is the propeptide of calcitonin devoid of hormonal activity . Normally , procalcitonin is produced in the C-cells of the thyroid gland . In healthy humans procalcitonin levels are undetectable ( 0.1 ng/ml ) . During severe generalized infections ( bacterial , parasitic and fungal ) with systemic manifestations , procalcitonin levels may rise up to 100 ng/ml . In contrast , severe viral infections or inflammatory reactions of non-infectious origin do not or very moderately increase procalcitonin levels . The exact site of procalcitonin production is not exactly known but even large amounts of procalcitonin released during infections do not lead to an increase in plasma calcitonin level or activity ."
],
"offsets": [
[
0,
721
]
]
}
] |
[
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],
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35,
45
]
],
"normalized": [
{
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}
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},
{
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"procalcitonin"
],
"offsets": [
[
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100
]
],
"normalized": [
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"db_id": "C0072027"
}
]
},
{
"id": "IntensiveMedizin.70340381.eng.abstr-s2-t2",
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"text": [
"thyroid"
],
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[
135,
142
]
],
"normalized": [
{
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"db_id": "C0040134"
}
]
},
{
"id": "IntensiveMedizin.70340381.eng.abstr-s2-t3",
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"text": [
"thyroid gland"
],
"offsets": [
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135,
148
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],
"normalized": [
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},
{
"id": "IntensiveMedizin.70340381.eng.abstr-s3-t1",
"type": "umlsterm",
"text": [
"humans"
],
"offsets": [
[
162,
168
]
],
"normalized": [
{
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"db_id": "C0020114"
}
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},
{
"id": "IntensiveMedizin.70340381.eng.abstr-s3-t2",
"type": "umlsterm",
"text": [
"procalcitonin"
],
"offsets": [
[
169,
182
]
],
"normalized": [
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"db_id": "C0072027"
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},
{
"id": "IntensiveMedizin.70340381.eng.abstr-s4-t1",
"type": "umlsterm",
"text": [
"infections"
],
"offsets": [
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249,
259
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],
"normalized": [
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},
{
"id": "IntensiveMedizin.70340381.eng.abstr-s4-t2",
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],
"offsets": [
[
262,
271
]
],
"normalized": [
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"db_id": "C0521009"
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]
},
{
"id": "IntensiveMedizin.70340381.eng.abstr-s4-t3",
"type": "umlsterm",
"text": [
"parasitic"
],
"offsets": [
[
274,
283
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0521066"
}
]
},
{
"id": "IntensiveMedizin.70340381.eng.abstr-s4-t4",
"type": "umlsterm",
"text": [
"fungal"
],
"offsets": [
[
288,
294
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0521033"
}
]
},
{
"id": "IntensiveMedizin.70340381.eng.abstr-s4-t5",
"type": "umlsterm",
"text": [
"procalcitonin"
],
"offsets": [
[
328,
341
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0072027"
}
]
},
{
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[] |
[] |
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] |
IntensiveMedizin.70340388.eng.abstr
|
IntensiveMedizin.70340388.eng.abstr
|
[
{
"id": "IntensiveMedizin.70340388.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The principles of nutritional therapy , i . e . , to maintain lean body mass , to stimulate immunocompetence and reparatory functions such as wound healing , are similar for patients with acute renal failure and with other catabolic clinical conditions . The objectives , however , differ from those for patients with chronic renal failure because diets that satisfy minimal requirements will not be sufficient for an acute catabolic illness ."
],
"offsets": [
[
0,
443
]
]
}
] |
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[] |
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] |
IntensiveMedizin.70340401.eng.abstr
|
IntensiveMedizin.70340401.eng.abstr
|
[
{
"id": "IntensiveMedizin.70340401.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The interventional occlusion of atrial septal defects still represents an experimental approach . As in all intracardiac implants able the double umbrella device ( ASDOS ) is affected by late complications , particularly when involving umbrella thrombosis and umbrella dislocations . The demonstration of 4 case reports shows that late postinterventional complications can manifest in unspecific cardial and noncardial symptoms in patients with an ASDOS device . The diagnosis of a late complication was in all cases confirmed by transesophageal echocardiography and represents an indication for immediate surgical explantation . For early diagnosis and safe handling of late complications after ASDOS implantation the knowledge of the emergency physician about postinventional problems of this device is essential . Every ASDOS patient who is suspected of suffering from late postinterventional complications should undergo immediate transesophageal echocardiography . The emergency physician should get in touch with the implantation center immediately . Furthermore , the concept of interventional occlusion therapy of atrial septum defects needs further development to avoid late complications ."
],
"offsets": [
[
0,
1199
]
]
}
] |
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IntensiveMedizin.70340416.eng.abstr
|
IntensiveMedizin.70340416.eng.abstr
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"id": "IntensiveMedizin.70340416.eng.abstr-passage-0",
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"Intensive scores like APACHE II and SAPS II have been developed to estimate the probability of hospital mortality of ICU patients . They can be used to evaluate and compare the efficiency of intensive care units . The role of these multipurpose scores in studies concerning patients with a specific disease has yet to be defined . The aim of this study was to validate and compare the APACHE II and SAPS II score in patients with sepsis who were admitted to the medical intensive care unit of a university hospital . We examined retrospectively 140 patients who presented with the clinical signs of severe sepsis or septic shock according to the American Consensus Conference . The physiologic and anamnestic variables for both scores were evaluated at the time the diagnosis of sepsis was made and on the third treatment day . The 60 female ( 43% ) and 80 male ( 57% ) patients had a mean ( +/- SA ) age of 48 +/- 16.7 years . 87 of the patients ( 62% ) required mechanical ventilation , 35 ( 25% ) needed hemodialysis or hemofiltration , 12 ( 9% ) required resuscitation . The mean stay on the ICU was 14 +/- 12.6 days . Mortality at day 28 was 50/140 ( 36% ) ; the overall hospital mortality was 57/140 ( 41% ) . The predicted mortality according to APACHE II was 35% ; according to SAPS II ( 25% ) , the standardized mortality ratios ( SMR ) were 1.2 resp. 1.4. Goodness of fit analyses proved a sufficient calibration for the APACHE II score and significant differences ( p = 0.01 ) of observed and predicted mortality for the SAPS II score . Subgroup analyses were performed for patients with different underlying disease and for patients with or without septic shock . Patients without underlying disease ( WD , n = 55 ) , severe underlying disease ( SD , n = 38 ) or immunosuppressive disease ( ID , n = 47 ) had a significantly different observed mortality of 25% ( WD ) vs. 45% ( SD ) vs. 55% ( ID ) ( p 0.01 ) . Patients without septic shock had a mortality rate of 11% , in contrast to patients with shock , who had a mortality of 47% ( p 0.001 ) . Neither the influence of the underlying disease nor of septic shock were detected by any of the two scores . While the mortality risk of patients without shock was overestimated [ SMR 0.5 ( Apache ) resp. 0.73 ( SAPS ) ] , the risk of patients with shock was underestimated by both scores [ SMR 1.2 ( APACHE ) resp. 1.6 ( SAPS ) ] ."
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] |
[] |
[] |
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IntensiveMedizin.70340426.eng.abstr
|
IntensiveMedizin.70340426.eng.abstr
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{
"id": "IntensiveMedizin.70340426.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Introduction : The APACHE II score is a well-known measure of illness severity and is widely used for patient classification and outcome prediction in critically ill patients . Since 1993 , the surgical intensive care unit ( ICU ) in Cologne-Merheim uses the APACHE II score for assessment of quality of care by comparing actual versus predicted mortality . The subgroup of trauma patients was identified as showing higher mortality rates than expected from scoring . A comparison with trauma-specific score systems can prove the appropriateness of the APACHE II score in trauma patients . Methods : All trauma patients in the surgical intensive care unit within an 18 months period were identified . All patients had a routine prospective APACHE II assessment . Hospital records and pre-hospital emergency physician protocols for all trauma patients were reviewed and trauma-specific prognostic scores ( ISS , RTS , TRISS ) were calculated . Subgroup analyses ( head injury ; severity of trauma ; age ) were performed . Results : Among 938 patients treated in the surgical ICU , 91 trauma patients were identified ; 11 of them died ( 12.1% ) . The mean APACHE II score at ICU entry for this group was 10.0 , which corresponds to an estimated 7.1% risk of death ( RODAPACHE ) . The standardized mortality ratio ( SMR ) is , thus , 1.70. Trauma-specific scoring systems reveal higher risk of death estimates : mean ISS = 26.3 ( RODISS = 20% ) , mean RTS = 6.38 ( RODRTS = 6 - 13% ) , and mean TRISS = 0.78 ( RODTRISS = 22% ) . Subgroup analysis shows under-estimation of ROD by APACHE II in elderly patients and patients with head injuries . Conclusion : The results of APACHE II score assessment in the group of trauma patients should be interpreted carefully since the actual risk of death is under-estimated . A parallel assessment of trauma-specific scoring systems like TRISS should always accompany risk of death estimates in these type of patients ."
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IntensiveMedizin.70340432.eng.abstr
|
IntensiveMedizin.70340432.eng.abstr
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"The objective of this study was to investigate whether the structure of the Mainz Emergency Medical Services ( EMS ) system warrants an adequate care of emergency patients a ) within a certain time-frame , b ) in any part of the city . We analyzed the influence of the city's infrastructural factors as well as bystander resuscitation upon structure and outcome elements of quality . The EMS system investigated serves a population of 190 000 in an 80 km2 area with four emergency ambulances manned with EMT-Ds and 1 physician-staffed Mobile Intensive Care Unit ( MICU ) in a two-tiered system . From February 1992 until July 1993 we prospectively collected data from 171 out-of-hospital cardiac arrests of non-traumatic etiology . Twenty-four of the patients were discharged from hospital ( 14% ) . Patients with ventricular fibrillation as first ECG-diagnosis had a 28% discharge rate ( 19 of 69 ) . The time interval from call reception at the dispatch center until arrival of the emergency ambulance at the scene was 5 min , and 8 min for the MICU , respectively , which indicates a proper deployment of the vehicles . Both teams then took 0.83 min to reach the patient after leaving their vehicles , which indicates a suitable city structure for a swift patient access . Although short in median , single time intervals in peripheral parts of the city were delayed . This turned out to be a problem in cases when the MICU was not preceded by an emergency ambulance as first tier , which happened in 30% of the cases . Rescue teams had a significantly shorter access to patients collapsing in a public place as compared to patients collapsing at home ( 0.5 vs. 1 min , p = 0.01 ) . Survival rates were also significantly higher in the first group ( 29 vs. 11% , p = 0.039 ) . With a rate of 25% bystander resuscitation turned out to be a problem . Half of these bystanders were medical professionals , leaving a layperson resuscitation rate of 13% . With the following system changes the problems identified in our investigation could be solved , and the overall effectiveness of the system could be improved : ..."
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[] |
[] |
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] |
IntensiveMedizin.70340442.eng.abstr
|
IntensiveMedizin.70340442.eng.abstr
|
[
{
"id": "IntensiveMedizin.70340442.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Several new approaches are available for early defibrillation . One example is semiautomatic defibrillators used by the first arriving emergency staff . The recommendations for introducing emergency medical technician ( EMT ) defibrillation in Germany are based either on the results in cities with so called doctor-manned-ambulances or the experiences of the German multi-center-study . This analysis intends to contribute data to an EMT defibrillation program in cities with a so called rendezvous-system . Methods : In a prospective study a EMT-defibrillation group ( = DG ) was compared with a standard group ( basic life support by EMTs and defibrillation by emergency physicians ) ( = SG ) and a control group ( emergency physicians starting resuscitation alone or together with EMTs ) ( = CG ) . In the DG semiautomatic defibrillators from Laerdal ( Heartstart 3000 ) were used . Successfully resuscitated patients were followed up with the Glasgow Coma Scale ( GCS ) , the Pittsburgh Brain Stem Score ( PBSS ) , and Pittsburgh Cerebral ( CPC ) and Overall Performance Categorie ( OPC ) . Results : Over 13 months 43 patients were included , primarily presenting with ventricular fibrillation ( VF ) . Depending on the first arriving emergency staff the patients were allocated to the DG ( n = 12 ) , to the SG ( n = 18 ) or to the CG ( n = 13 ) . DG and SG did not differ significantly concerning the primary survival rate or the long-term prognosis ( primary successful 8.3% vs. 38.9% , definite successful 0% vs. 27.8% ) . The primary survival rate in the DG was significantly lower than in the CG ( 8.3% vs. 61.5% ) . In the long term survival rate there were no significant differences . In the DG significantly less patients received bystander CPR ( 8.3% ) than in the other groups ( 55.6% and 69.2% ) . Neither the variable \" witnessed collapes \" nor \" bystander CPR \" had a significant influence for the outcome of the patients in this study . The average response time for the first arriving rescue team was 5.5 +/- 2.4 min , without a significant difference between the groups . Conclusions : A comparison of this study with American , European and German recommendations for EMT defibrillation programms revealed some deviations . Bystander CPR seems to be of special importance as well as the time interval between defibrillation and the arrival of the emergency physician . A benefit of EMT defibrillation could not be demonstrated in our \" rendezvous-system \" , possibly because the time interval was less than 4 min ( 3.5 min ) . Since the result is in accordance with the German multi-center-study , a critical consideration of a EMT defibrillation program seems to be necessary in \" Rendezvous-systems \" ."
],
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] |
[] |
[] |
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] |
IntensiveMedizin.70340466.eng.abstr
|
IntensiveMedizin.70340466.eng.abstr
|
[
{
"id": "IntensiveMedizin.70340466.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Diagnosis of bacterial infection and/or sepsis in critically ill patients is a common problem in intensive care medicine . White blood count , C-reactive protein ( CRP ) , and the erythrocyte sedimentation rate ( ESR ) are often used in the differential diagnosis of infection versus SIRS ( systemic inflammatory response syndrome ) due to noninfectious causes . There is a number of non-infectious stimuli to cause leucocytosis and CRP elevation . In the last 3 years , Procalcitonin ( PCT ) was determined to be a marker of severe bacterial infection , especially sepsis . PCT appears to have several advantages ; it is of non-hepatic ( yet unknown ) origin and useful in patients with hepatic insufficiency . There is no PCT-increase in acute graft-rejection , viral disease , and autoimmune disorders . Some studys showed a prognostic value of PCT in sepsis due to peritonitis and pancreatitis . PCT appears to be a new and helpful tool in the diagnosis and treatment of critically ill patients . Further studies are needed to finally established PCT in the daily management of critically ill patients . At this time significantly higher costs are the major detraction to daily or frequent measurements ."
],
"offsets": [
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IntensiveMedizin.70340472.eng.abstr
|
IntensiveMedizin.70340472.eng.abstr
|
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"The maintenance and/or improvement of medical quality standards despite limited resources can only be achieved through structural improvements which are accompanied by appropriate and effective rationalization measures . Decisions on economy measures in intensive care medicine which do not result in a quality reduction require fundamental and differentiated knowledge of ( 1 ) the degree of severity of the illness and the treatment result , ( 2 ) the actual patient-related service expenditure , and the costs connected with it . The precondition for this is the patient-related service data acquisition with the determination of individual , cumulative treatment costs , as well as the average costs per day . By including the individual personnel expenditure required in the cost analysis , it appears that , in the future , it will be possible to timely recognize and favorably influence undesirable developments in requirement planning and the allocation of resources . Additionally , the transparency of the provided services represents an objective basis for the discussion of resource allocation ."
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IntensiveMedizin.70340480.eng.abstr
|
IntensiveMedizin.70340480.eng.abstr
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{
"id": "IntensiveMedizin.70340480.eng.abstr-passage-0",
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"Oncological emergencies are life-threatening events that are directly or indirectly related to a malignancy . They are caused by compression of organs , metabolic imbalances or therapy-related adverse events . The latter can be minimized by modern means of supportive care . In case of emergency in tumor patients , differential diagnosis should always include non-tumor related causes ( e . g . cardiac infarction ) . Oncological emergencies should always be treated in an intensive care unit if there is a curative treatment option . Intensive care of an emergency during palliative oncological treatment has to be throughly weighed against the disadvantages . Abolishing an oncological emergency in a terminally ill patient will only lead to other complications . There is , for example , no justification for dialysis in a uremic patient with advanced renal cell carcinoma ."
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}
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IntensiveMedizin.70340491.eng.abstr
|
IntensiveMedizin.70340491.eng.abstr
|
[
{
"id": "IntensiveMedizin.70340491.eng.abstr-passage-0",
"type": "abstract",
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"Quality control concepts will provide a basis for inter-Unit comparisons . A classification in : appraisal of structure , assessment of process and assessment of outcomes provides a systematical approach to quality assurance and control . Patient data management sytsems including Score systems can be useful to evaluate diagnostic , therapeutic and scientific standards . Quality is matched with the already mentioned cost effectiveness . The use of computerized systems allows to determine the costs for a patient . But it is important to consider some principles of economic analysis . An explicit statement of the perspective of the analysis should be provided and an explicit description of the benefits of the programme or technology being studied ."
],
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0,
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]
}
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] |
[] |
[] |
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"id": "IntensiveMedizin.70340491.eng.abstr-s3-r3-t1.1-t4.1",
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},
{
"id": "IntensiveMedizin.70340491.eng.abstr-s3-r4-t2.1-t1.1",
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"id": "IntensiveMedizin.70340491.eng.abstr-s6-r1-t2.1-t1.1",
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IntensiveMedizin.70340501.eng.abstr
|
IntensiveMedizin.70340501.eng.abstr
|
[
{
"id": "IntensiveMedizin.70340501.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Chronic respiratory failure ( CRF ) is caused by a decrease in the capacity of the respiratory muscles ( e . g . , neuromuscular diseases ) , or an increase in load ( e . g . , kypho-scoliosis or obstructive lung disease ) or both . CRF is characterized by hypercapnia and hypoxemia . The degree of hypercapnia is directly related to the increase of the load and decrease of the capacity of the respiratory muscles and acts , therefore , as an indicator ."
],
"offsets": [
[
0,
455
]
]
}
] |
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}
]
},
{
"id": "IntensiveMedizin.70340501.eng.abstr-s1-t2",
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"text": [
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],
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95,
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}
]
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{
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137
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}
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"id": "IntensiveMedizin.70340501.eng.abstr-s5-t4",
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"id": "IntensiveMedizin.70340501.eng.abstr-s5-t5",
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"id": "IntensiveMedizin.70340501.eng.abstr-s6-t1",
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] |
IntensiveMedizin.70340527.eng.abstr
|
IntensiveMedizin.70340527.eng.abstr
|
[
{
"id": "IntensiveMedizin.70340527.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Given the high mortality of severe sepsis and septic shock , immunomodulation has been considered as an attractive adjunct therapy . Many agents have been studied that have the therapeutic potential to interfere with cytokines and other pathways which are activated during sepsis . Drugs having the properties to neutralize lipopolysaccharides have also been considered . So far all the large clinical trials with immunomodulating agents ( HA1A, E5, anti TNF antibodies , ILra ) have been shown to be of marginal or of no benefit . In certain trials results were indecisive , or mortality was increased which led to discontinue the studies . In certain other trials , like those on antibodies against TNF , some positive effects were seen in subcategories of patients . Thus , new trials are on their ways . So far the results of early trials has forced investigators to re-examine the concept of immunomodulation , and to redefine strategies to optimally use agents in a way that benefits the host , while not putting him at risk ."
],
"offsets": [
[
0,
1032
]
]
}
] |
[
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{
"id": "IntensiveMedizin.70340527.eng.abstr-s1-t2",
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IntensiveMedizin.70340538.eng.abstr
|
IntensiveMedizin.70340538.eng.abstr
|
[
{
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"text": [
"Angiotensin-converting enzyme ( ACE ) inhibitors are established drugs for the treatment of patients with heart failure and hypertension . There is mounting evidence to suggest that ACE inhibitors may be used for different indications as well . The rational for the use of ACE inhibitors is to block the vasoconstrictive effects mediated by angiotensin II . The hemodynamic profile of ACE inhibitors is modified by additional effects such as interference with the degredation of bradykinin and accumulation of prostaglandin and nitric oxide ( NO ) . Thus ACE inhibitors may be successful in preventing the negative effects of vasoconstriction on regional circulation . Since vasoconstriction , particularly of the mesenteric vasculature appears to be largely mediated by the renin-angiotensin-axis , ACE inhibitors are assumed to be effective in treating or avoiding gut mucosal hypoperfusion . The critically ill intensive care patient at risk of developing multiple organ dysfunction syndrome ( MODS ) is still a major therapeutic challenge . Intravenous preparations of ACE inhibitors may broaden our therapeutic armamentarium for these patients . However , several questions about the exact mechanisms of ACE inhibitors , such as the ideal substance and the optimal dose , are still open . Moreover , further work needs to be done to definitely determine whether ACE inhibitors may be helpful to prevent or treat ( micro- ) circulatory catastrophe in these patients . The pharmacologic properties of ACE inhibitors provide an exciting stepping stone for future research in this field ."
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] |
IntensiveMedizin.70340549.eng.abstr
|
IntensiveMedizin.70340549.eng.abstr
|
[
{
"id": "IntensiveMedizin.70340549.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Purpose : Echocardiog-raphy is often used as a diagnostic tool in critically ill patients in intensive care units . We performed this prospective study to assess the general value of this technique in patients on a medical intensive care unit . Patients : 118 patients ( 68 men , 50 women , age 53 +/- 13 years ) were echocardiographically investigated because of an uncertain diagnosis or hemodynamic situation . Transthoracic echocardiography was performed in 55% of our patients , transesophageal echocardiography in 45% and both in 21% . Transesophageal echocardiography was always indicated in patients with suspected endocarditis , aortic dissection or embolic events . Methods : For the investigations an electronic sector scanner was used ( mainly Aloka SSD 2200 ) , the transesophageal echocardiographic transducer was a multiplane probe . Results : In 38% of patients a new main diagnosis was established or the suspected diagnosis could be more precisely defined . In 5% the echocardiographic investigation was life saving because of the initiated management . In 20% the echocardiography revealed no further information regarding the patients hemodynamics . In 6% the echocardiographic investigation led to a wrong diagnosis . In most of these cases the subsequent investigation revealed the true diagnosis ( e . g . virusmyocarditis ) . No major complications occurred . Conclusion : Echocardiography is diagnostically helpful in many and lifesaving in some patients . Thus , training in both transthoracic and transesophageal echocardiography should be part of teaching programs for residents in medical intensive care ."
],
"offsets": [
[
0,
1634
]
]
}
] |
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] |
IntensiveMedizin.70340563.eng.abstr
|
IntensiveMedizin.70340563.eng.abstr
|
[
{
"id": "IntensiveMedizin.70340563.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Thrombolytic therapy of pulmonary embolism with recombinant tissue-type plasminogen activator ( rt-PA ) has proved to be an established method ; but intra- and postoperatively , there is a high risk of bleeding complications . A 50-year old female with familiar hypophosphatasia and suspected deep venous thrombosis was undergoing osteosynthesis of a femoral fracture . Intraoperatively , petCO2 suddenly dropped , paCO2 rose , and circulatory arrest occurred . CPR was started immediately with closed-chest cardiac compression and intravenous application of catecholamines . While continuing CPR , surgery was stopped , the wound was sealed provisionally , and the patient was transferred to the ICU . Because of suspected massive pulmonary embolism , thrombolytic therapy with rt-PA in a total dosage of 100 mg was begun . 2.25 hours after the onset of circultory arrest , and 1.5 hours after the beginning of thrombolysis , the patient's hemodynamic patterns under high-dosage catecholamines were satisfactory . The bleeding after thrombolysis and coagulopathy required massive blood transfusions . The situation was also complicated by lesions of the liver , spleen and small intestines , which required surgical intervention , and acute renal failure , which had to be treated with transient hemofiltration . Twenty-eight days after receiving CPR , the patient was discharged from the ICU . A diagnosis of pulmonary embolism was established by clinical signs , capnometry , blood gas analysis , and electrocardiography . Due to the requirements of the emergency situation ( ongoing CPR ) , further diagnostic tools were not used . The patient survived without any neurological deficiency , despite the extended 135-min use of CPR , and despite massive bleeding due to surgical trauma , and to performing CPR in the presence of fibrinolytica ."
],
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] |
IntensiveMedizin.70340569.eng.abstr
|
IntensiveMedizin.70340569.eng.abstr
|
[
{
"id": "IntensiveMedizin.70340569.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The clinical appearance of acute renal failure has changed during recent years . Thus , vascular access must be revisited . The choice of the catheter type and its location are depende on the treatment mode , continuous or intermittent . Additional parameters are given by hypotension , overhydration , acidosis and hyperpotassemia . Early and late complications are described ."
],
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[
0,
378
]
]
}
] |
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],
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],
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"id": "IntensiveMedizin.70340569.eng.abstr-s4-t1",
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273,
284
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362
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] |
[] |
[] |
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IntensiveMedizin.70340577.eng.abstr
|
IntensiveMedizin.70340577.eng.abstr
|
[
{
"id": "IntensiveMedizin.70340577.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Heart failure may be defined as a reduced physical per-formance frequently caused by a defect in myocardial contraction . According to the New York Heart Association , the severity of heart failure is classified into four grades ( NYHA I-IV ) . Predominantly underlying causes are coronary artery disease , hypertension , cardiomyopathies and valvular heart diseases ."
],
"offsets": [
[
0,
368
]
]
}
] |
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"id": "IntensiveMedizin.70340577.eng.abstr-s1-t2",
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"db_id": "C0243067"
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"id": "IntensiveMedizin.70340577.eng.abstr-s2-t1",
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"Heart"
],
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148,
153
]
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{
"id": "IntensiveMedizin.70340577.eng.abstr-s2-t2",
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"text": [
"Association"
],
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154,
165
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"db_id": "C0004083"
}
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{
"id": "IntensiveMedizin.70340577.eng.abstr-s2-t3",
"type": "umlsterm",
"text": [
"heart"
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[
184,
189
]
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"db_id": "C0018787"
}
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"id": "IntensiveMedizin.70340577.eng.abstr-s2-t4",
"type": "umlsterm",
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"New York"
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139,
147
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"db_id": "C0027976"
}
]
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{
"id": "IntensiveMedizin.70340577.eng.abstr-s3-t1",
"type": "umlsterm",
"text": [
"causes"
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270,
276
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"db_id": "C0015127"
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"id": "IntensiveMedizin.70340577.eng.abstr-s3-t2",
"type": "umlsterm",
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290,
296
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"db_id": "C0003842"
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"id": "IntensiveMedizin.70340577.eng.abstr-s3-t3",
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],
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307,
319
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"id": "IntensiveMedizin.70340577.eng.abstr-s3-t5",
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],
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322,
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"db_id": "C0027049"
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352,
357
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"id": "IntensiveMedizin.70340577.eng.abstr-s3-t7",
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"id": "IntensiveMedizin.70340577.eng.abstr-s3-t8",
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352,
366
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},
{
"id": "IntensiveMedizin.70340577.eng.abstr-s3-t9",
"type": "umlsterm",
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],
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281,
304
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"db_id": "C0010068"
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},
{
"id": "IntensiveMedizin.70340577.eng.abstr-s3-t10",
"type": "umlsterm",
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[
343,
366
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0018824"
}
]
}
] |
[] |
[] |
[
{
"id": "IntensiveMedizin.70340577.eng.abstr-s2-r1-t1.1-t2.1",
"type": "location_of",
"arg1_id": "IntensiveMedizin.70340577.eng.abstr-s3-t1",
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{
"id": "IntensiveMedizin.70340577.eng.abstr-s2-r2-t4.1-t2.1",
"type": "result_of",
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] |
IntensiveMedizin.70340655.eng.abstr
|
IntensiveMedizin.70340655.eng.abstr
|
[
{
"id": "IntensiveMedizin.70340655.eng.abstr-passage-0",
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"Gram-positive bacteria are increasing in importance as causes of hospital-acquired infections . Staphylococci , streptococci , and enterococci are the aetiological organisms in up to 60% of nosocomial blood stream infections . Resistance to available antimicrobial agents is increasing and includes , in particular , resistance to penicillinase-resistant penicillins ( oxacillin and methicillin ) , fluoroquinolones ( ciprofloxacin ) , aminoglycosides ( gentamicin ) , lincosamides ( clindamycin ) , and macrolides ( erythromycin ) amongst staphylococci , resistance to glycopeptides ( vancomycin and teicoplanin ) amongst enterococci , and resistance to penicillin and some other -lactams to pneumococci . This emergence of multiple bacterial resistance to various antimicrobial agents of different antibiotic classes now poses one of the most serious threat to our ability to treat patients . New antimicrobial agents for effective therapy of infection with antimicrobial-resistant gram-positive species are urgently needed . New compounds show high in vitro activity against gram-positive cocci , especially against methicillin-resistant S. aureus or glycopeptid-resistant enterococci , and are under rapid development and clinical investigation . This review article summarizes the available data on the susceptibility of gram-positive cocci , such as S. aureus , coagulase-negative staphylococci , enterococci and pneumococci to individual antimicrobial agents ."
],
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IntensiveMedizin.70340664.eng.abstr
|
IntensiveMedizin.70340664.eng.abstr
|
[
{
"id": "IntensiveMedizin.70340664.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Bacterial infections still pose a threat to intensive care patients . The progression of an infection once contracted often leads to severe sepsis with subsequent organ failure and death . Despite better understanding of the pathophysiological course , the hyperinflammatory reaction cannot be retained . Granulocyte colony-stimulating factor ( G-CSF ) regulates the multiplication and differentiation of neutrophil precursors and modulates neutrophil function . Since 1987 , recombinant human G-CSF ( r-metHuG-CSF ) has been approved for the treatment of chemotherapy-induced neutropenia , all forms of congenital neutropenia , as well as for the mobilization of progenitor cells for peripheral progenitor cell transplantation . Since G-CSF modulates the function of neutrophil granulocytes and since its endogenous production is induced by bacterial infection , it has been assumed to have an important role in bacterial infections . In animal models of infections it has been shown that rhG-CSF could significantly increase the survival rates and reduced the endogenous production of TNF- . In healthy volunteers G-CSF improves the granulocyte function and has an anti-inflammatory effect on the cytokine network . First clinical studies in patients with infections ( pneumonia ) as well as surgical intensive care patients have shown that the administration of G-CSF is safe and that it might have a beneficial effect on the clinical course ."
],
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IntensiveMedizin.70340675.eng.abstr
|
IntensiveMedizin.70340675.eng.abstr
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"This review summarizes briefly pathophysiology , clinical definitions , pathogenesis , risk factors , diagnostic procedures and principles of therapy and prophylaxis of ischemic stroke . Ischemic stroke is defined as a localized lack of cerebral perfusion mainly due to cardioembolic or arterial-embolic occlusion of cerebral arteries or hemodynamic or microangiographic reduction of cerebral blood flow . We focused on pathophysiological mechanisms with potential clinical relevance as the role of oxygen and glucose concentration , the therapeutic time window , the role of excitatory neurotransmitters , Ca2+-influx, free radicals , and the development of ischemic brain edema . Based on this data the need of an urgent initiation of diagnostic workup and therapy is emphasized . This includes the early basic management with monitoring of blood pressure , ECG , oxygen and blood glucose concentration , and the balance of the water and electrolyte supply . Since specific therapeutic and prophylactic interventions are based on an exact diagnosis with respect to the pathogenesis , the need of an urgent diagnostic workup including clinical examination , laboratory baseline , vascular ultrasound , cranial CT-scan , ECG , and echocardiography is emphazised . Based on these results appropriate management of certain pathogenetic stroke subgroups is discussed . New data about the effectiveness of basic care , treatment of edema , neuroprotective agents , and thrombolysis is presented . Indications for the therapy with intravenous heparin , vitamin K-antagonists , antiplatelet drugs , and surgical procedures are summarized ."
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IntensiveMedizin.70340706.eng.abstr
|
IntensiveMedizin.70340706.eng.abstr
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"The aim of the study was to evaluate if a combined physiologic-therapeutic scoring system ( MARIS = Marburger Intensive Score ) offers better outcome prediction compared to scoring systems , which are based either only physiologically ( APACHE II = Acute Physiology and Chronic Health Evaluation II ) or only therapeutically ( TISS = Therapeutic Intervention Scoring System ) in medical intensive care medicine . Main outcome parameters employed were hospital mortality , severity of disease classification and length of hospital stay . During a 12-months period ( 1993/94 ) , 531 consecutive patients ( ICU stay > 4 hours ) being admitted to a medical ICU of a tertiary care university hospital were prospectively investigated . The day-1-scores of MARIS , APACHE II , and TISS were determined and the patients were followed until hospital discharge or death . There was no advantage in using the combined scoring system ( MARIS ) neither in discrimination between survival and non-survival ( hospital mortality ; areas under the ROC-curve : MARIS = 0.84 , APACHE II = 0.86 , TISS = 0.78 ) nor in severity classification ( relationship between day-1-scores and hospital mortality : p 0.001 ( chi2-Test) in all three systems ) . In contrast only for the combined system ( MARIS ) , a dependence of length of hospital stay from day-1-scores in the analysis of survivors only and in the analysis of all patients ( survivors and non-survivors ) ( p 0.001 ; ANOVA ) could be demonstrated . In conclusion the combined physiologic-therapeutic scoring system ( MARIS ) did not offer a better outcome prediction concerning hospital mortality and severity classification compared to the established systems in critically ill patients . Its use may be advantageous in evaluating the relationship between day-1-scores and length of hospital stay , which for economical reasons has become a parameter of growing interest in intensive care medicine ."
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] |
IntensiveMedizin.70340715.eng.abstr
|
IntensiveMedizin.70340715.eng.abstr
|
[
{
"id": "IntensiveMedizin.70340715.eng.abstr-passage-0",
"type": "abstract",
"text": [
"A case of unilateral pulmonary edema occurred after treatment of acute smoke inhalation injury complicated by respiratory failure . An endotracheal tube had been placed into the right main stem bronchus due to emergency treatment at the site of a large fire in a nursing home . Local dexamethasone prophylaxis had been administered by aerosol application via the tube before it was corrected 1 h later in the intensive care unit . We conclude that early local administration of aerosolized dexamethasone is an effective prophylaxis after severe acute smoke inhalation injury in patients undergoing ventilatory support and that the contralateral development of toxic pulmonary edema was most probably due to the inappropriate drug access ."
],
"offsets": [
[
0,
738
]
]
}
] |
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] |
[] |
[] |
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IntensiveMedizin.70340725.eng.abstr
|
IntensiveMedizin.70340725.eng.abstr
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"Acute spinal cord injury affects more than 3000 individuals per year with predominantly young people between 15 and 20 years of age being involved . Analysis of the modern emergency management has revealed that the prognosis of acute spinal trauma depends decisively on the initial treatment at the accident site as well as good acute emergency care . Therefore , there is the urgent need to brain the medical staff so that injuries are diagnosed correctly and appropriate treatment be performed . The first hours after the accident are decisive , because injuries due to the primary and especially secondary trauma are difficult to correct later . Besides the fate of the individual patient , the care provider has to be aware of the high economic impact caused by intensive care , long lasting rehabilitation , as well as post rehabilitative care ."
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[] |
[] |
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IntensiveMedizin.70340744.eng.abstr
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"This contribution summarizes a discussion of several experts on the field of clinical nutrition , which was held in Evangelische Akademie Loccum , Germany , May 7 - 8 , 1997. For nutritional therapy , the critically and \" stable \" in- or out-patients have to be differentiated . Nutritional status can be assessed by Subjective Global Assessment ( SGA ) as clinical observation of the patient is basic during clinical nutrition . Laboratory routine parameters ( e . g . , serum electrolytes , glucose , urea , triglycerides ) also have to be analyzed from a nutritional point of view . For stable in- and out-patients , body composition analysis ( B. I. A. ) is frequently used for calculation of body cell and extracellular mass . For long-term parenteral and enteral nutrition , skin fold measurement is useful . However , the value of body composition analysis is still open with respect to repeated measurements during the course of parenteral and enteral nutrition . Due to extraordinary expansion of the extracellular space and body water , monofrequent B. I. A. using the present calculation formula is not a reliable tool in the critically ill. Energy requirements can be calculated for \" stable \" patients by use of the body weight by Harris-Benedict formula , while this may be inadequate in the critically ill. A very useful tool is indirect calorimetry for measurement of energy expenditure and substrate oxidation rates . Even in the critically ill , daily assessment of respiratory quotient ( RQ ) is obviously not required . In these patients , calorie and substrate administration should be primarily based on metabolic activity and feeding tolerance . Further discussions and consensus statements about the standard assessment during nutritional therapy will be necessary . Because nutritional therapy is supportive treatment in many patients , even avoidance of malnutrition or deterioration of nutritional status have to be considered therapeutic success . In terms of cost-benefit ratio , benefit of clinical nutrition has to be also evaluated according to \" outcome \" parameters like complication rate , mortality , and hospital stay . For long-term studies , nutritional state and quality of life should be the preferred end points . With regard to complexity of diseases this may be hardly demonstrated , unless there is need for more well-designed , controlled , randomized trials in the future ."
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1818
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"id": "IntensiveMedizin.70340744.eng.abstr-s13-t2",
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{
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{
"id": "IntensiveMedizin.70340744.eng.abstr-s13-t3",
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1859
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{
"id": "IntensiveMedizin.70340744.eng.abstr-s13-t4",
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{
"id": "IntensiveMedizin.70340744.eng.abstr-s13-t6",
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1818
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{
"id": "IntensiveMedizin.70340744.eng.abstr-s13-t7",
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1931
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2000
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{
"db_name": "UMLS",
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{
"db_name": "UMLS",
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{
"id": "IntensiveMedizin.70340744.eng.abstr-s14-t2",
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2000
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{
"id": "IntensiveMedizin.70340744.eng.abstr-s14-t3",
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2038
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{
"db_name": "UMLS",
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{
"id": "IntensiveMedizin.70340744.eng.abstr-s14-t4",
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2117
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2134
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{
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"id": "IntensiveMedizin.70340744.eng.abstr-s14-t6",
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2149
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"db_name": "UMLS",
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"id": "IntensiveMedizin.70340744.eng.abstr-s15-t1",
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2218
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2178
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"db_name": "UMLS",
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"id": "IntensiveMedizin.70340744.eng.abstr-s15-t3",
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2198
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"db_name": "UMLS",
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"id": "IntensiveMedizin.70340744.eng.abstr-s15-t4",
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2218
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"id": "IntensiveMedizin.70340744.eng.abstr-s16-t1",
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"id": "IntensiveMedizin.70340744.eng.abstr-s16-t2",
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2348
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"id": "IntensiveMedizin.70340744.eng.abstr-s16-t3",
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2418
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"db_name": "UMLS",
"db_id": "C0016884"
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] |
[] |
[] |
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IntensiveMedizin.70340758.eng.abstr
|
IntensiveMedizin.70340758.eng.abstr
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[] |
[] |
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IntensiveMedizin.70340765.eng.abstr
|
IntensiveMedizin.70340765.eng.abstr
|
[
{
"id": "IntensiveMedizin.70340765.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Acute oxalosis is an important disorder causing serious abnormalities . Acute oxalosis may come about by ethylene glycol poisoning ; in recent years iatrogenic cases of acute oxalosis have also been described following iv treatments of naftidrofuryl , a vasodilator . Furthermore , chronic asymptomatic intestinal oxalosis may turn symptomatic by a superimposed major load of oxalate . Acute oxalosis results in acute renal failure ; in addition oxalate-induced angiopathy may be associated with necrosis of affected tissue . The diagnosis of acute oxalosis requires a demonstration of oxalate crystals in the urine and in other affected tissues . In terms of therapy , hemodialysis should be used promptly in cases of ethylene glycol poisoning and a worsening of the renal function . In cases of a secondary chronic intestinal oxalosis prophylactic measures such as maintaining an elevated urinary flow rate and prescribing oral calcium supplements will be helpful ."
],
"offsets": [
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0,
967
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]
}
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] |
[] |
[] |
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] |
IntensiveMedizin.70340769.eng.abstr
|
IntensiveMedizin.70340769.eng.abstr
|
[
{
"id": "IntensiveMedizin.70340769.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Contrast media-associated nephrotoxicity continues to be a relevant cause of acute renal failure especially in patients with pre-existing renal insufficiency . Alterations in renal hemodynamics and direct tubular toxicity by contrast media are the primary factors believed to be responsible for contrast media-associated nephrotoxicity . We review recent insights into the pathogenesis of this complication and summarize prophylactic strategies focusing on hydration , vasoactive pharmacological agents , alternative contrast media , and \" prophylactic hemodialysis \" ."
],
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[
0,
569
]
]
}
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"id": "IntensiveMedizin.70340769.eng.abstr-s3-t7",
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"id": "IntensiveMedizin.70340769.eng.abstr-s3-t8",
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] |
[] |
[] |
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IntensiveMedizin.70340778.eng.abstr
|
IntensiveMedizin.70340778.eng.abstr
|
[
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],
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[
0,
424
]
]
}
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}
] |
[] |
[] |
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"id": "IntensiveMedizin.70340778.eng.abstr-s2-r4-t1.1-t4.1",
"type": "manages",
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"id": "IntensiveMedizin.70340778.eng.abstr-s2-r5-t1.1-t3.1",
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{
"id": "IntensiveMedizin.70340778.eng.abstr-s2-r6-t3.2-t4.1",
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"id": "IntensiveMedizin.70340778.eng.abstr-s2-r8-t5.2-t3.1",
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"id": "IntensiveMedizin.70340778.eng.abstr-s2-r10-t8.1-t3.1",
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"id": "IntensiveMedizin.70340778.eng.abstr-s2-r11-t4.1-t3.1",
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}
] |
IntensiveMedizin.70340797.eng.abstr
|
IntensiveMedizin.70340797.eng.abstr
|
[
{
"id": "IntensiveMedizin.70340797.eng.abstr-passage-0",
"type": "abstract",
"text": [
"A 67 year old male was admitted to our hospital due to subacute anterior myocardial infarction with development of a ventricular thrombus . After fibrinolytic therapy with Streptokinase , he underwent PTCA/Stent-Implantation . From the beginning Heparin was administered intravenously ( 25 000 IU daily ) . After development of thromboembolism of the right leg on the 10th day , a thrombectomy was performed with primarily good results . The next day angiography showed multiple embolisms in the right lower leg . Fibrinolytic therapy with Urokinase showed no results nor did intraarterial administration of Prostavasin . Regarding a thrombocytopenia with a platelet count of 41 000/µl on day 11 , the diagnosis of heparin-induced thrombocytopenia type II was considered . Heparin induced platelet activation ( HIPA ) test showed the evidence of a heparin-dependent antibody . After elimination of heparin , the therapy was performed with the low-molecular-weight-heparinoid Org 10172 although factor Xa activity could not be controlled . Subsequently , Phenprocoumon was administered . Thereafter , platelet count raised to normal levels . The clinical image improved quickly , although complete restitution could not be achieved ."
],
"offsets": [
[
0,
1232
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]
}
] |
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"id": "IntensiveMedizin.70340797.eng.abstr-s1-t2",
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"male"
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{
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{
"id": "IntensiveMedizin.70340797.eng.abstr-s1-t4",
"type": "umlsterm",
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"anterior"
],
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64,
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]
},
{
"id": "IntensiveMedizin.70340797.eng.abstr-s1-t5",
"type": "umlsterm",
"text": [
"infarction"
],
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84,
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"id": "IntensiveMedizin.70340797.eng.abstr-s1-t6",
"type": "umlsterm",
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}
]
},
{
"id": "IntensiveMedizin.70340797.eng.abstr-s1-t7",
"type": "umlsterm",
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],
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129,
137
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}
]
},
{
"id": "IntensiveMedizin.70340797.eng.abstr-s1-t8",
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"myocardial infarction"
],
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[
73,
94
]
],
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"db_id": "C0027051"
}
]
},
{
"id": "IntensiveMedizin.70340797.eng.abstr-s1-t9",
"type": "umlsterm",
"text": [
"with development"
],
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111
]
],
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"db_id": "C0243107"
}
]
},
{
"id": "IntensiveMedizin.70340797.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"therapy"
],
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[
159,
166
]
],
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},
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}
]
},
{
"id": "IntensiveMedizin.70340797.eng.abstr-s2-t2",
"type": "umlsterm",
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"Streptokinase"
],
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172,
185
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],
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"db_id": "C0038418"
}
]
},
{
"id": "IntensiveMedizin.70340797.eng.abstr-s2-t3",
"type": "umlsterm",
"text": [
"fibrinolytic therapy"
],
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[
146,
166
]
],
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"db_id": "C0040044"
}
]
},
{
"id": "IntensiveMedizin.70340797.eng.abstr-s3-t1",
"type": "umlsterm",
"text": [
"Heparin"
],
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246,
253
]
],
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"db_id": "C0019134"
}
]
},
{
"id": "IntensiveMedizin.70340797.eng.abstr-s4-t1",
"type": "umlsterm",
"text": [
"development"
],
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313,
324
]
],
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}
]
},
{
"id": "IntensiveMedizin.70340797.eng.abstr-s4-t2",
"type": "umlsterm",
"text": [
"thromboembolism"
],
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[
328,
343
]
],
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"db_id": "C0040038"
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]
},
{
"id": "IntensiveMedizin.70340797.eng.abstr-s4-t3",
"type": "umlsterm",
"text": [
"right"
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351,
356
]
],
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"db_id": "C0035621"
}
]
},
{
"id": "IntensiveMedizin.70340797.eng.abstr-s4-t4",
"type": "umlsterm",
"text": [
"leg"
],
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[
357,
360
]
],
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"db_id": "C0023216"
}
]
},
{
"id": "IntensiveMedizin.70340797.eng.abstr-s4-t5",
"type": "umlsterm",
"text": [
"thrombectomy"
],
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381,
393
]
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"db_id": "C0162578"
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{
"id": "IntensiveMedizin.70340797.eng.abstr-s5-t1",
"type": "umlsterm",
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"angiography"
],
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451,
462
]
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"db_id": "C0002978"
}
]
},
{
"id": "IntensiveMedizin.70340797.eng.abstr-s5-t2",
"type": "umlsterm",
"text": [
"embolisms"
],
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479,
488
]
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"db_id": "C0013922"
}
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{
"id": "IntensiveMedizin.70340797.eng.abstr-s5-t3",
"type": "umlsterm",
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"leg"
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}
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"id": "IntensiveMedizin.70340797.eng.abstr-s6-t1",
"type": "umlsterm",
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"therapy"
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"db_id": "C0087111"
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}
]
},
{
"id": "IntensiveMedizin.70340797.eng.abstr-s6-t2",
"type": "umlsterm",
"text": [
"Urokinase"
],
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540,
549
]
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{
"id": "IntensiveMedizin.70340797.eng.abstr-s6-t3",
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604
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{
"id": "IntensiveMedizin.70340797.eng.abstr-s6-t4",
"type": "umlsterm",
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],
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]
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{
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"id": "IntensiveMedizin.70340797.eng.abstr-s6-t6",
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"intraarterial administration"
],
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[
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604
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"db_id": "C0021439"
}
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},
{
"id": "IntensiveMedizin.70340797.eng.abstr-s7-t1",
"type": "umlsterm",
"text": [
"thrombocytopenia"
],
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[
634,
650
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],
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"db_name": "UMLS",
"db_id": "C0040034"
}
]
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{
"id": "IntensiveMedizin.70340797.eng.abstr-s7-t2",
"type": "umlsterm",
"text": [
"platelet"
],
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[
658,
666
]
],
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"db_id": "C0005821"
}
]
},
{
"id": "IntensiveMedizin.70340797.eng.abstr-s7-t3",
"type": "umlsterm",
"text": [
"diagnosis"
],
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702,
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"db_id": "C0348026"
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]
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{
"id": "IntensiveMedizin.70340797.eng.abstr-s7-t4",
"type": "umlsterm",
"text": [
"thrombocytopenia"
],
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[
731,
747
]
],
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"db_id": "C0040034"
}
]
},
{
"id": "IntensiveMedizin.70340797.eng.abstr-s7-t5",
"type": "umlsterm",
"text": [
"platelet count"
],
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[
658,
672
]
],
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"db_name": "UMLS",
"db_id": "C0032181"
}
]
},
{
"id": "IntensiveMedizin.70340797.eng.abstr-s8-t1",
"type": "umlsterm",
"text": [
"Heparin"
],
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[
773,
780
]
],
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"db_name": "UMLS",
"db_id": "C0019134"
}
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},
{
"id": "IntensiveMedizin.70340797.eng.abstr-s8-t2",
"type": "umlsterm",
"text": [
"platelet"
],
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789,
797
]
],
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"db_id": "C0005821"
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]
},
{
"id": "IntensiveMedizin.70340797.eng.abstr-s8-t3",
"type": "umlsterm",
"text": [
"test"
],
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[
818,
822
]
],
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"db_name": "UMLS",
"db_id": "C0076174"
}
]
},
{
"id": "IntensiveMedizin.70340797.eng.abstr-s8-t4",
"type": "umlsterm",
"text": [
"heparin-dependent"
],
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[
848,
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]
],
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"db_id": "C0019134"
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},
{
"id": "IntensiveMedizin.70340797.eng.abstr-s8-t5",
"type": "umlsterm",
"text": [
"antibody"
],
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866,
874
]
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"db_id": "C0003241"
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]
},
{
"id": "IntensiveMedizin.70340797.eng.abstr-s8-t6",
"type": "umlsterm",
"text": [
"platelet activation"
],
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789,
808
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],
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"db_id": "C0032173"
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},
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"id": "IntensiveMedizin.70340797.eng.abstr-s9-t1",
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"heparin"
],
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{
"id": "IntensiveMedizin.70340797.eng.abstr-s9-t2",
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919
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"db_id": "C0087111"
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"db_id": "C0039798"
}
]
},
{
"id": "IntensiveMedizin.70340797.eng.abstr-s9-t3",
"type": "umlsterm",
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],
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{
"id": "IntensiveMedizin.70340797.eng.abstr-s9-t4",
"type": "umlsterm",
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"db_id": "C0031444"
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]
},
{
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"type": "umlsterm",
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"platelet"
],
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1108
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],
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"db_id": "C0005821"
}
]
},
{
"id": "IntensiveMedizin.70340797.eng.abstr-s11-t2",
"type": "umlsterm",
"text": [
"platelet count"
],
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1100,
1114
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0032181"
}
]
}
] |
[] |
[] |
[
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"id": "IntensiveMedizin.70340797.eng.abstr-s1-r1-t7.1-t4.1",
"type": "developmental_form_of",
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{
"id": "IntensiveMedizin.70340797.eng.abstr-s1-r2-t2.1-t7.1",
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},
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"id": "IntensiveMedizin.70340797.eng.abstr-s1-r4-t7.1-t2.1",
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},
{
"id": "IntensiveMedizin.70340797.eng.abstr-s1-r5-t7.1-t1.1",
"type": "associated_with",
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"arg2_id": "IntensiveMedizin.70340797.eng.abstr-s11-t1",
"normalized": []
},
{
"id": "IntensiveMedizin.70340797.eng.abstr-s1-r6-t4.1-t9.1",
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{
"id": "IntensiveMedizin.70340797.eng.abstr-s1-r7-t2.1-t5.1",
"type": "associated_with",
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"normalized": []
},
{
"id": "IntensiveMedizin.70340797.eng.abstr-s1-r8-t5.1-t2.2",
"type": "associated_with",
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"arg2_id": "IntensiveMedizin.70340797.eng.abstr-s9-t2",
"normalized": []
},
{
"id": "IntensiveMedizin.70340797.eng.abstr-s1-r9-t1.1-t6.1",
"type": "measurement_of",
"arg1_id": "IntensiveMedizin.70340797.eng.abstr-s11-t1",
"arg2_id": "IntensiveMedizin.70340797.eng.abstr-s8-t6",
"normalized": []
},
{
"id": "IntensiveMedizin.70340797.eng.abstr-s1-r10-t5.1-t6.1",
"type": "evaluation_of",
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"arg2_id": "IntensiveMedizin.70340797.eng.abstr-s8-t6",
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] |
IntensiveMedizin.80350003.eng.abstr
|
IntensiveMedizin.80350003.eng.abstr
|
[
{
"id": "IntensiveMedizin.80350003.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The potential role of nutrition to influence survival in the critically-ill is discussed . Increasing benefits are described to enteral nutrition but there remain some patients who have high mortality in whom only parenteral nutrition is possible . The clinical relevance of glutamine in parenteral nutrition is reviewed in the context of how it might influence survival from severe illness ."
],
"offsets": [
[
0,
392
]
]
}
] |
[
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],
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]
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}
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],
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}
]
},
{
"id": "IntensiveMedizin.80350003.eng.abstr-s1-t3",
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],
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45,
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]
],
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"id": "IntensiveMedizin.80350003.eng.abstr-s2-t1",
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"id": "IntensiveMedizin.80350003.eng.abstr-s2-t2",
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"patients"
],
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[
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]
},
{
"id": "IntensiveMedizin.80350003.eng.abstr-s2-t3",
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"text": [
"mortality"
],
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191,
200
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},
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"db_id": "C0026565"
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},
{
"id": "IntensiveMedizin.80350003.eng.abstr-s2-t4",
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]
},
{
"id": "IntensiveMedizin.80350003.eng.abstr-s2-t5",
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]
},
{
"id": "IntensiveMedizin.80350003.eng.abstr-s3-t1",
"type": "umlsterm",
"text": [
"glutamine"
],
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[
275,
284
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],
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{
"id": "IntensiveMedizin.80350003.eng.abstr-s3-t2",
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{
"id": "IntensiveMedizin.80350003.eng.abstr-s3-t3",
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}
]
},
{
"id": "IntensiveMedizin.80350003.eng.abstr-s3-t4",
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"text": [
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"normalized": [
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"db_id": "C0030547"
},
{
"db_name": "UMLS",
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}
]
}
] |
[] |
[] |
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IntensiveMedizin.80350010.eng.abstr
|
IntensiveMedizin.80350010.eng.abstr
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"During the last decade , many investigations were conducted in order to understand the mechanisms involved in the development of acute lung injury ( ALI ) or acute respiratory distress syndrome ( ARDS ) . However , the increasing knowledge , instead of clarification , leads us to realize that these terms may assemble a wide variety of lung pathologies . Indeed , many circumstances can result in these syndromes and no particular factor has been defined to distinguish ARDS of one etiology from another . We are still ignorant about which factors lead to the extended inflammation from pneumonia to ARDS , while it is not clear whether the timing of events are determined by some mediators . Furthermore , in the clinical arena , there is no clear distinction between pneumonia , severe pneumonia which may lead to ALI and then ARDS . Finally , the results of all these studies should have allowed us to investigate new therapeutical approaches while none seems to emerge . This review is an analysis by an ICU clinician of the different points of view of these syndromes and intends to give a global vision of the numerous factors implied , emphasizing the complex interactions between them . The present state about new potential treatments directed on mediators is summarized ."
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[] |
[] |
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IntensiveMedizin.80350022.eng.abstr
|
IntensiveMedizin.80350022.eng.abstr
|
[
{
"id": "IntensiveMedizin.80350022.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Intensive care patients bear a high risk to manifest \" systemic inflammatory response syndrome ( SIRS ) \" , sepsis , septic shock and multiple organ dysfunction which are associated with a high mortality rate . As a consequence of an initial infection or trauma , a hyperinflammatory activation of the immune system follows and an anti-inflammatory response ( named \" compensatory anti-inflammatory response syndrome ( CARS ) \" occurs consecutively . This latter state manifests as systemic immune dysfunction , anergy and causes increased susceptibility to infections . Results of clinical and experimental studies are discussed providing evidence for the use of a hematopoietic growth factor named granulocyte colony-stimulating factor ( G-CSF ) to counteract this immunodeficiency . In non-neutropenic , posttraumatic/postoperative patients with an increased risk of sepsis , G-CSF increases neutrophil count and function and decreases the incidence of sepsis . Moreover , recent studies suggest that G-CSF contributes to an anti-inflammatory cytokine response in hyper-inflammatory states and is considered as a promising therapeutic agent given prophylactically . Thus , G-CSF may activate neutrophils on the one hand and at the same time may counteract progression of an excessive inflammatory reaction due to anti-inflammatory effects on the other hand . In this context , G-CSF treatment appears to be a promising therapeutic option in intensive care patients at risk of sepsis , SIRS , CARS and the \" mixed antagonistic response syndrome ( MARS ) \" . Regarding effective therapy of hyperinflammatory states of sepsis , SIRS and MARS as well as the secondary , transient immunodeficiency of CARS and MARS by G-CSF , the drug will have to be administered to accurately defined patient groups and due to optimal timing and dosage schedules ."
],
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]
]
}
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] |
[] |
[] |
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] |
IntensiveMedizin.80350034.eng.abstr
|
IntensiveMedizin.80350034.eng.abstr
|
[
{
"id": "IntensiveMedizin.80350034.eng.abstr-passage-0",
"type": "abstract",
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"The aim of the present study was to determine the acute and long-term outcome of in-hospital and out-of-hospital cardiopulmonary resuscitation ( CPR ) in a single community hospital ."
],
"offsets": [
[
0,
183
]
]
}
] |
[
{
"id": "IntensiveMedizin.80350034.eng.abstr-s1-t1",
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4,
7
]
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"db_id": "C0108800"
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},
{
"id": "IntensiveMedizin.80350034.eng.abstr-s1-t2",
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],
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129,
142
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{
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]
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{
"id": "IntensiveMedizin.80350034.eng.abstr-s1-t3",
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"CPR"
],
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[
145,
148
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0007203"
}
]
},
{
"id": "IntensiveMedizin.80350034.eng.abstr-s1-t4",
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"single"
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[
156,
162
]
],
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{
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"db_id": "C0087136"
}
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},
{
"id": "IntensiveMedizin.80350034.eng.abstr-s1-t5",
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[
163,
172
]
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"db_id": "C0009462"
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{
"id": "IntensiveMedizin.80350034.eng.abstr-s1-t6",
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],
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[
173,
181
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0019994"
}
]
},
{
"id": "IntensiveMedizin.80350034.eng.abstr-s1-t7",
"type": "umlsterm",
"text": [
"cardiopulmonary resuscitation"
],
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[
113,
142
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0007203"
}
]
},
{
"id": "IntensiveMedizin.80350034.eng.abstr-s1-t8",
"type": "umlsterm",
"text": [
"community hospital"
],
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[
163,
181
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0020003"
}
]
}
] |
[] |
[] |
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{
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"type": "carries_out",
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{
"id": "IntensiveMedizin.80350034.eng.abstr-s1-r2-t4.1-t7.1",
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"arg2_id": "IntensiveMedizin.80350034.eng.abstr-s1-t7",
"normalized": []
},
{
"id": "IntensiveMedizin.80350034.eng.abstr-s1-r3-t7.1-t8.1",
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},
{
"id": "IntensiveMedizin.80350034.eng.abstr-s1-r9-t4.1-t7.1",
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{
"id": "IntensiveMedizin.80350034.eng.abstr-s1-r10-t1.1-t4.1",
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{
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},
{
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{
"id": "IntensiveMedizin.80350034.eng.abstr-s1-r14-t4.1-t3.1",
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"arg2_id": "IntensiveMedizin.80350034.eng.abstr-s1-t3",
"normalized": []
},
{
"id": "IntensiveMedizin.80350034.eng.abstr-s1-r15-t4.1-t3.1",
"type": "carries_out",
"arg1_id": "IntensiveMedizin.80350034.eng.abstr-s1-t4",
"arg2_id": "IntensiveMedizin.80350034.eng.abstr-s1-t3",
"normalized": []
},
{
"id": "IntensiveMedizin.80350034.eng.abstr-s1-r16-t8.1-t7.1",
"type": "carries_out",
"arg1_id": "IntensiveMedizin.80350034.eng.abstr-s1-t8",
"arg2_id": "IntensiveMedizin.80350034.eng.abstr-s1-t7",
"normalized": []
}
] |
IntensiveMedizin.80350042.eng.abstr
|
IntensiveMedizin.80350042.eng.abstr
|
[
{
"id": "IntensiveMedizin.80350042.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Background : There are three fields where the the biochemical cardiac markers creatine kinase ( CK ) , its isoenzyme MB ( CK-MB ) , myoglobin , and troponin can play an important role : ( 1 ) the primary diagnosis of acute myocardial infarction ( AMI ) , ( 2 ) identification of patients suffering from unstable angina with minor myocardial damage ( MMD ) and consecutively increased risk for major cardiovascular events , and ( 3 ) assessment of coronary reperfusion after intravenous thrombolysis ."
],
"offsets": [
[
0,
500
]
]
}
] |
[
{
"id": "IntensiveMedizin.80350042.eng.abstr-s1-t1",
"type": "umlsterm",
"text": [
"markers"
],
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[
70,
77
]
],
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{
"db_name": "UMLS",
"db_id": "C0005516"
}
]
},
{
"id": "IntensiveMedizin.80350042.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
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],
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[
78,
86
]
],
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{
"db_name": "UMLS",
"db_id": "C0010286"
}
]
},
{
"id": "IntensiveMedizin.80350042.eng.abstr-s1-t3",
"type": "umlsterm",
"text": [
"kinase"
],
"offsets": [
[
87,
93
]
],
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[] |
[] |
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IntensiveMedizin.80350050.eng.abstr
|
IntensiveMedizin.80350050.eng.abstr
|
[
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"text": [
"Guillain Barré syndrome ( GBS ) is an acute , inflammatory , demyelinating disease of the peripheral nerve system . Clinical hallmarks are symmetric muscle paralysis , areflexia and pronouced autonomic disturbances . Respiratory failure and cardiovascular instability are the main reasons for intensive care support in patients with GBS . The present report of a 33 year old man with Miller-Fisher syndrome , a variant of the GBS , discusses the management of patients with GBS in the intensive care unit ."
],
"offsets": [
[
0,
506
]
]
}
] |
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IntensiveMedizin.80350056.eng.abstr
|
IntensiveMedizin.80350056.eng.abstr
|
[
{
"id": "IntensiveMedizin.80350056.eng.abstr-passage-0",
"type": "abstract",
"text": [
"We report the case of a 43-year-old woman who had a cardiogenic shock due to an acute inferior myocardial infarction . Her husband and a general practitioner living in the neighborhood initially performed cardiopulmonary resuscitation . A prehospital emergency physician found ventricular fibrillation when he arrived after 20 minutes . It was impossible to achieve stable rhythm by 42 attemps of defibrillation . Therefore , the patient was carried to our clinic under ongoing cardiopulmonary resuscitation . A cardiologist was informed with radio signal . Percutaneous cardiopulmonary support ( pCPS ) was implanted in the emergency department after 100 minutes of cardiac arrest . After stabilizing the hemodynamic situation by pCPS ( 4-5 l/min ) it was possible to transfer the patient to the catheterization laboratory . Angiography revealed proximal occlusion of a dominant right coronary artery . After successful angioplasty it was possible to reestablish stable sinus rhythm by single defibrillation . By use of intra-aortic balloon pump ( IABP ) the flow rate of pCPS was reduced every two hours . After 10 hours of support pCPS was explaned . IABP was needed for three days . The patient was discharged from hospital without any relevant neurological deficits after nine weeks . By using pCPS it is possible to stabilize the patient's hemodynamic situation and to perform diagnostic and therapeutic procedures if other means of resuscitation do not suffice . The use of pCPS in resuscitation is indicated in circulatory arrest if further therapeutic options seem promising ."
],
"offsets": [
[
0,
1585
]
]
}
] |
[
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"id": "IntensiveMedizin.80350056.eng.abstr-s1-t1",
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"woman"
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36,
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{
"id": "IntensiveMedizin.80350056.eng.abstr-s1-t2",
"type": "umlsterm",
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"shock"
],
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64,
69
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{
"id": "IntensiveMedizin.80350056.eng.abstr-s1-t3",
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"text": [
"infarction"
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106,
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{
"id": "IntensiveMedizin.80350056.eng.abstr-s1-t4",
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"cardiogenic shock"
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{
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] |
[] |
[] |
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] |
IntensiveMedizin.80350062.eng.abstr
|
IntensiveMedizin.80350062.eng.abstr
|
[
{
"id": "IntensiveMedizin.80350062.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The diagnosis of urinary tract infection in renal transplant patients is important because unrecognized bacterial infection may lead - in the worst case - to graft loss . Between January 1995 and January 1997 , we therefore obtained bladder catheter urine samples in 31 female allograft recipients when voided urine samples repeatedly showed pyuria ( > =10 WC per microscope field ( x40)) and significant bacteriuria ( > = ; 105/ml) combined with vaginal contamination ( plenty of squamous epithelial cells , mixed bacterial growth ) . Results : In 55 % ( 17/31 ) , diagnosis of urinary tract infection was confirmed by single bladder catheterization ; in 26 % ( 8/31 ) , urinary tract infection could be excluded , and in 19 % ( 6/31 ) , bladder colonization without pyuria was found . Thus , 45 % of the patients with abnormal voided urine samples did not need antimicrobials . After single dose antibiotic therapy with 500 mg Ciprofloxacin , given immediately after catheterization , no infectious complications occurred . Diagnostic single bladder catheterization is a simple , safe and - compared to suprapubic aspiration - barely invasive method for the diagnosis or exclusion of urinary tract infection in female renal transplant patients with higher risk for complications due to an acute bladder infection and non-conclusive voided urine samples ."
],
"offsets": [
[
0,
1356
]
]
}
] |
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"transplant"
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IntensiveMedizin.80350095.eng.abstr
|
IntensiveMedizin.80350095.eng.abstr
|
[
{
"id": "IntensiveMedizin.80350095.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Oxygen radicals play a dual role in sepsis . On the one hand they contribute to the killing of pathogenic microorganisms , but on the other , produced in excess , they may cause severe disruption of proteins , DNA , RNA , and carbohydrates which leads , e . g . , to membrane leakages ( lipid peroxidation ) and a capillary leak syndrome . In septic patients plasma levels of malondialdehyde and conjugated dienes are increased and those of -tocopherol , retinol , and -carotene are decreased . Moreover , the urinary excretion of nitrite , nitrate , and vitamin A is increased . The results in the literature on the formation of oxygen radicals by leucocytes ( respiratory burst ) are conflicting . Although several pharmacological and nutritional antioxidants have been used in experimental studies , relevant clinical studies are lacking . Dosage recommendations for septic patients are given for vitamin E ( 300 mg/d ) , vitamin C ( 1000 mg/d ) , -carotene ( 20 mg/d ) , and also for trace elements responsible for the activity of oxygen radical reducing enzymes , such as copper ( 3 mg/d ) , zinc ( 10 - 30 mg/d ) , and selenium ( 300 - 500 µg/d)."
],
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}
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] |
IntensiveMedizin.80350106.eng.abstr
|
IntensiveMedizin.80350106.eng.abstr
|
[
{
"id": "IntensiveMedizin.80350106.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Immunosuppression-related Candida infections may be most successfully treated using biological response modifiers and recombinant cytokines to enhance expression of host pro-inflammatory and antimicrobial mediators , notably tumor necrosis factor-alpha ( TNF- ) , interleukin 1 ( IL-1), and gamma-interferon ( gamma-IFN ) . Important but unappreciated differences in the immunopathophysiology of fungal vs. bacterial infections make such cytokine priming appear contrary to current strategies for reducing cytokine-mediated organ injury and mortality due to gram-negative bacteremia and endotoxemia . Optimistically , preclinical studies to date have found that the coadministration of such immunoadjuvants does not compromise , and actually may improve , the efficacy of synthetic antifungals . Such combination therapies should continue to be evaluated in animal models of Candida infection which otherwise progress to lethal shock or chronic disseminated disease despite aggressive use of existing antifungal agents ."
],
"offsets": [
[
0,
1020
]
]
}
] |
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] |
[] |
[] |
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] |
IntensiveMedizin.80350114.eng.abstr
|
IntensiveMedizin.80350114.eng.abstr
|
[
{
"id": "IntensiveMedizin.80350114.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The aim of this study was to evaluate the effect of ventilation with positive endexspiratory pressure on regional systolic wall motion of the left ventricle using transesophageal echocardiography . The study group consisted of 17 patients with acute respiratory failure admitted to our intensive care unit . Patients with regional wall motion abnormalities were excluded . The transesophageal probe was placed in standard position for evaluation of the left ventricle ( LV ) in the four chamber view ( long axis ) and for monitoring LV cross section in the transgastric view . Continuous videotape recordings were made during ZEEP ventilation ( zero end-expiratory pressure ) , continued after mode switch to PEEP 16 cm H2O over 5 minutes and again after removal of PEEP 16 cm H2O over 5 minutes . The endocardial contours were examined in stop frame video projection . Wall motion was analysed semiautomatically using a centerline model . Regional motion of the LV wall was evaluated by systolic percentage changes of segmental hemiaxis ."
],
"offsets": [
[
0,
1039
]
]
}
] |
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"id": "IntensiveMedizin.80350114.eng.abstr-s1-t2",
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],
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52,
63
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},
{
"id": "IntensiveMedizin.80350114.eng.abstr-s1-t3",
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"pressure"
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"id": "IntensiveMedizin.80350114.eng.abstr-s1-t4",
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] |
IntensiveMedizin.80350124.eng.abstr
|
IntensiveMedizin.80350124.eng.abstr
|
[
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"id": "IntensiveMedizin.80350124.eng.abstr-passage-0",
"type": "abstract",
"text": [
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],
"offsets": [
[
0,
359
]
]
}
] |
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210,
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"normalized": [
{
"db_name": "UMLS",
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}
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] |
[] |
[] |
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IntensiveMedizin.80350132.eng.abstr
|
IntensiveMedizin.80350132.eng.abstr
|
[
{
"id": "IntensiveMedizin.80350132.eng.abstr-passage-0",
"type": "abstract",
"text": [
"We report the case of a 39 year old male i . v. drug addict who ingested approximately 50 g of Aspirin in a suicideal attempt . The patient was admitted to our intensive care unit 12 hours after Aspirin ingestion . On admission the patient presented with the clinical signs of a severely depressed mental status ( Glasgow-Coma Scale 7 ) accompanied by the clinical sign of severe hyperventilation . A corresponding respiratory alkalosis was noticed ( pH 7.5 , pCO2 16.9 mmHg , stand . bicarbonate 18.9 mmol/l , anion gap 14.1 ) . The maximum serum level of salicylate was 1494 mg/l . Immediately gastric lavage with administration of charcoal and cathartics was performed . I. v. sodium bicarbonate and fluids were given . Hemofiltration therapy was performed because of the high serum salicylate concentration and the progressive deterioration of the mental status . After three hemofiltration treatments , the patients mental status improved . Three days after admission , he was transferred to a normal ward from where he was discharged two days later in good condition ."
],
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0,
1074
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]
}
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] |
[] |
[] |
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IntensiveMedizin.80350137.eng.abstr
|
IntensiveMedizin.80350137.eng.abstr
|
[
{
"id": "IntensiveMedizin.80350137.eng.abstr-passage-0",
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"text": [
"Percutaneous dilatational tracheotomy is a procedure for inserting a tracheal cannula without a large incision , without extensive dissection of pretracheal tissue , and without exposure of the trachea . The early complications of the technique are usually minor and late complications are rare . Although it is a simple procedure , it is not a minor operation . Users must be familiar with the technique , the indications and contra-indications for the procedure , as well as the complications . These are described . Proper training of the operation and knowledge of the procedure will avoid unnecessary complications . Percutaneous dilatational tracheotomy is a relatively new technique for inserting a cannula in the tracheal lumen . It can be done at the patients bedside with only minimal complications . A short history , the indications and contraindications , the early and late complications of the technique , and comparisons with other techniques as well as with conventional open tracheotomy are reviewed ."
],
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0,
1019
]
]
}
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IntensiveMedizin.80350183.eng.abstr
|
IntensiveMedizin.80350183.eng.abstr
|
[
{
"id": "IntensiveMedizin.80350183.eng.abstr-passage-0",
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"For many years the multiple organ dysfunction syndrome has been on the top of medical articles about the intensive care patient . While severity scores deal with the 1st ICU day physiology , the organ dysfunction systems aim to take in account the duration type and severity of physiologic disturbances during the ICU stay . Most of the published systems have been created by a panel of experts , giving to each dysfunction a number of points , usually 1 to 4 , according to the severity . Only 2 systems are different : the MODS of Marshall et al. and the Logistic Organ Dysfunction LOD system of Le Gall et al. , both published recently ( 1995 and 1996 ) . They differ from the others because first they were created either from a literature review ( MDOS ) or from a logistic regression ( LOD ) , and secondly , because neither takes into account the therapy . Besides , the LOD system , when used on the 1st ICU day , has statistical qualities which are very promising . The LOD system is now used each consecutive day on septic patients in an European multicenter study ."
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}
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[] |
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IntensiveMedizin.80350203.eng.abstr
|
IntensiveMedizin.80350203.eng.abstr
|
[
{
"id": "IntensiveMedizin.80350203.eng.abstr-passage-0",
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"text": [
"Nitric oxide is an endogenous vasodilator which is produced by several different NO synthases . It plays a major role in the control of vascular tone . In sepsis or after administration of endotoxin or cytokines , large amounts of NO are generated causing generalized systemic vasodilation . Free hemoglobin is able to bind NO and , thus , causes vasoconstriction in healthy and septic individuals leading to an increase in systemic blood pressure and systemic vascular resistance . It also causes pulmonary hypertension , a generally undesired effect . Free hemoglobin restores vascular reactivity which is impaired in sepsis and appears to improve the depressed myocardial contractility in sepsis . Glomerular filtration rate falls in sepsis and improves after hemoglobin administration . Urinary output increases . In healthy animals hemoglobin causes a decrease in pancreatic and renal blood flow , but in sepsis regional blood flow is not influenced by hemoglobin . The interactions between hemoglobin and the host defense system are at present incompletely understood . Infusion of large amounts of hemoglobin may cause methemoglobinemia leading to impaired oxygenation . Clinical indications of hemoglobin in the future may be its use as a blood substitute to reduce transfusion requirements and as a NO scavenger in sepsis . More studies evaluating short-term and long-term safety and efficacy are warranted prior to clinical use of hemoglobin ."
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] |
IntensiveMedizin.80350213.eng.abstr
|
IntensiveMedizin.80350213.eng.abstr
|
[
{
"id": "IntensiveMedizin.80350213.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Background : The use of intravenous heparin is essential for the treatment of unstable angina and acute myocardial infarction . A significant rebound of thrombin generation within 6 to 10 hours after termination of heparin infusion has been reported . This time window is clinically critical as the incidence of recurrent ischemia peaks in this period . It has therefore been recommended to gradually taper heparin infusion continously rather than to discontinue it abruptly . However , it is not known which dosing procedure is useful and whether it definitly reduces thrombin rebound ."
],
"offsets": [
[
0,
587
]
]
}
] |
[
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],
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20
]
],
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"db_id": "C0042153"
}
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},
{
"id": "IntensiveMedizin.80350213.eng.abstr-s1-t2",
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"heparin"
],
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36,
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]
],
"normalized": [
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],
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]
},
{
"id": "IntensiveMedizin.80350213.eng.abstr-s1-t4",
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"text": [
"angina"
],
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[
87,
93
]
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],
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115,
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"unstable angina"
],
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93
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],
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},
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],
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125
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161
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172
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"db_id": "C0079411"
}
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},
{
"id": "IntensiveMedizin.80350213.eng.abstr-s2-t3",
"type": "umlsterm",
"text": [
"heparin"
],
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[
215,
222
]
],
"normalized": [
{
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]
},
{
"id": "IntensiveMedizin.80350213.eng.abstr-s3-t1",
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],
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308
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},
{
"id": "IntensiveMedizin.80350213.eng.abstr-s3-t3",
"type": "umlsterm",
"text": [
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],
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},
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"id": "IntensiveMedizin.80350213.eng.abstr-s3-t4",
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"text": [
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},
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"id": "IntensiveMedizin.80350213.eng.abstr-s4-t1",
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"text": [
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],
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407,
414
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],
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},
{
"id": "IntensiveMedizin.80350213.eng.abstr-s5-t1",
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},
{
"id": "IntensiveMedizin.80350213.eng.abstr-s5-t2",
"type": "umlsterm",
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"db_id": "C0040018"
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]
}
] |
[] |
[] |
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IntensiveMedizin.80350228.eng.abstr
|
IntensiveMedizin.80350228.eng.abstr
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[
{
"id": "IntensiveMedizin.80350228.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Since continuous hemofiltration was first described by Peter Kramer as a new form of renal replacement therapy , it has undergone many changes , making it a widely accepted treatment modality for acute renal failure in critically ill patients . Concomitantly , new insights into the pathogenesis of severe sepsis and septic shock have led to a recent form of immunomodulating therapy for septic shock . A number of clinical trials investigating the effects of anti-endotoxin or anti-cytokine interventions did not consistently show an improvement in survival in patients with sepsis or septic schock . Another possibility of immunotherapy is the removal of various pro-inflammatory substances including endotoxin , cytokines , oxygen free radicals , and arachidonic acid metabolites by hemofiltration . In animal models of acute septic shock , hemofiltration has shown beneficial hemodynamic effects and even an increased short term survival . In clinical studies , although not prospective and randomized , continuous hemofiltration sometimes showed a increased patient survival rate , which was possibly due to the removal of pro-inflammatory substances . Therefore , continuous hemofiltration seems promising as an adjunctive treatment modality in severe sepsis and septic shock . However , more experimental and clinical research should be performed in order to establish the optimal hemofiltration modalities in terms of membrane , ultrafiltration rate , buffer solution , and timing of the intervention ."
],
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0,
1510
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"id": "IntensiveMedizin.80350228.eng.abstr-s8-r6-t1.1-t6.1",
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"id": "IntensiveMedizin.80350228.eng.abstr-s8-r7-t1.1-t5.1",
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] |
IntensiveMedizin.80350243.eng.abstr
|
IntensiveMedizin.80350243.eng.abstr
|
[
{
"id": "IntensiveMedizin.80350243.eng.abstr-passage-0",
"type": "abstract",
"text": [
"Critical illness polyneuropathy ( CIP ) may occur in up to 70% of septic patients and multiple organ failure patients . Typical clinical signs of CIP are the difficulty to wean the patient from artificial respiration , a symmetrical flaccid quadriparesis/-plegia that is more pronounced in the distal parts of the limbs , reduced or absent deep tendon reflexes , and muscular atrophy . This article describes and discusses the clinical and electrophysiological features and clinical outcomes , physiopathological concepts , therapeutic implications , and the complex differential diagnosis of CIP from a neurological point of view , focusing on disorders of the nervous system and myopathic abnormalities . The data available in the literature were reviewed and compared to our own findings in order to deduce a clinical definition of CIP . It is a particular aim of this work to emphasize the crucial importance of electrophysiological investigation and monitoring in the classification of the nature and extent of neuromuscular disturbances in critically ill patients ."
],
"offsets": [
[
0,
1071
]
]
}
] |
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31
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"Critical illness"
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"id": "IntensiveMedizin.80350243.eng.abstr-s2-t1",
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"id": "IntensiveMedizin.80350243.eng.abstr-s2-t3",
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{
"id": "IntensiveMedizin.80350243.eng.abstr-s2-t4",
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"limbs"
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314,
319
]
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"id": "IntensiveMedizin.80350243.eng.abstr-s2-t5",
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"id": "IntensiveMedizin.80350243.eng.abstr-s2-t6",
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"id": "IntensiveMedizin.80350243.eng.abstr-s2-t7",
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"id": "IntensiveMedizin.80350243.eng.abstr-s2-t8",
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"id": "IntensiveMedizin.80350243.eng.abstr-s2-t9",
"type": "umlsterm",
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"id": "IntensiveMedizin.80350243.eng.abstr-s2-t10",
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"id": "IntensiveMedizin.80350243.eng.abstr-s3-t1",
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"id": "IntensiveMedizin.80350243.eng.abstr-s3-t2",
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"diagnosis"
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"db_id": "C0010340"
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]
}
] |
[] |
[] |
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"type": "degree_of",
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{
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{
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IntensiveMedizin.80350252.eng.abstr
|
IntensiveMedizin.80350252.eng.abstr
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"Acute brain tissue damage or systemic illnesses can lead to local or diffuse brain edema and raised intracranial pressure ( ICP ) . It is obvious that in all brain injuries additional factors ( metabolic disturbances , hypoxia and hypercapnia , circulatory instability ) aggravating brain edema and impairing recovery of viable neurons have to be treated immediately and consequently . Medical therapies for further treatment of elevated ICP depend not only on their mode of action and side effects but although on the specific illness . The different etiology and pathogenesis of developing brain edema and ICP elevation with either more local or generalized extension explain the different success of medical treatment strategies in severe head trauma compared to middle cerebral artery territory or complete hemispheric infarction . An algorithm for treatment of postischemic brain edema in acute hemispheric infarction was developed ."
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[] |
[] |
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IntensiveMedizin.80350261.eng.abstr
|
IntensiveMedizin.80350261.eng.abstr
|
[
{
"id": "IntensiveMedizin.80350261.eng.abstr-passage-0",
"type": "abstract",
"text": [
"In normal conditions , alveolar macorphage ( AM ) is the main cell that respond against to bacteria that reach lower airways . However , if the microbial inoculum is too high or too virulent to be stopped by AM alone , these cells recruit polymorphonuclear neutrophils ( PMN ) into the alveoli from the vascular compartment . Cytokines , such as tumor necrosis factor-alpha ( TNF- ) , interleukin-1-beta ( IL-1), interleukin-6 ( IL-6), and interleukin-8 ( IL-8), secreted by the AM are able to attract PMN enhanced for phagocytosis are ready to destroy the invading pathogens . However , excessive cytokine production has deleterious effects , with a systemic inflammatory response ( sepsis ) that can lead to multiorganic failure and death . Other cytokines like interleukin-10 ( IL-10) balance this response attenuating several inflammatory mechanisms . The inflammatory lung response in pneumonia has been well studied in animals and more recently in humans using bronchoalveolar lavage to measure some inflammatory mediators ( TNF- , IL-1, IL-6, IL-8). From these studies , it seems that first , the inflammatory response to pneumonia is compartmentalized for most cytokines ( in contrast to ARDS ) , except for IL-6 which is a general marker of inflammation . On the other hand , C-Reactive-Protein is an acute-phase protein synthesized by the liver through the stimuli of IL-6 that may be also an easy to measure marker of inflammation directly related to IL-6; second , some of these cytokines may be useful as prognostic markers ; third , there is no clear relationship between the local lung bacterial burden and the intensity of the inflammatory response ; fourth , the administration of G-CSF is a promising therapeutic approach still under clinical investigation . In the future the therapeutic goal in severe pneumonia will probably be to find the exact point at which inflammation is beneficial but not deleterious . The measurement of the inflammatory response could serve for this purpose ."
],
"offsets": [
[
0,
2006
]
]
}
] |
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] |
[] |
[] |
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IntensiveMedizin.80350270.eng.abstr
|
IntensiveMedizin.80350270.eng.abstr
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[
{
"id": "IntensiveMedizin.80350270.eng.abstr-passage-0",
"type": "abstract",
"text": [
"92 patients ( 11 f ) with severe alcohol withdrawal syndrome were treated symptomatically in an open , randomized study with i.v. Clonidine ( n=48; 46 y ; mean dose 2.3 +/- 1.4 mg/d ) or i.v. Clomethiazole ( n=48; 43 y ; mean dose 5.2 +/- 2.5 g/d ) . The severity of alcohol withdrawal was estimated by an max 25 point score system . Patients treated with Clonidine reached 13 ( 10-21 ) , those treated with Clomethiazole 14.5 ( 10-23 ) points at inclusion . Normalization of clinical symptoms ( score =5 ) within 5 days was observed in 84% of patients treated with Clonidine and in 60% patients treated with Clomethiazole ( p=0.054). There were 9.3% non-responders with Clonidine and 14.6% non-responders with Clomethiazole . There was no difference in necessity of parenteral nutrition at day 5 of therapy between both groups : 46.5% patients on Clonidine and 43.8% patients on Clomethiazole had enteral nutrition . We found respiratory complications ( especially necessity of assisted ventilation ) in 19% of patients on Clonidine , but in 44% patients on Clomethiazole on day 4 of therapy . Sedative concomitant medication was necessary in 84% of the Clonidine and 50% of the Clomethiazole patients . Overall tolerability of Clonidine was jedged as better compared to Clomethiazole , yet 6 severe adverse events were observed with Clonidine and only 2 with Clomethiazole . In conclusion therapy of severe alcohol withdrawal syndrome is possible with both compounds , Clonidine if combined with sedatives and Clomethiazole . Monotherapy with Clomethiazole was insufficient in about a half , Clonidine in 4/5 of the treated patients . Benzodiazepines are suitable for coadministration with Clonidine ; in combination with Clomethiazole they may prolong the duration of alcohol withdrawal . Inspite of lower administration of sedatives with Clomethiazole assisted ventilation and the necessity for tracheal aspiration was needed by more patients compared to Clonidine ."
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] |
IntensiveMedizin.80350281.eng.abstr
|
IntensiveMedizin.80350281.eng.abstr
|
[
{
"id": "IntensiveMedizin.80350281.eng.abstr-passage-0",
"type": "abstract",
"text": [
"The oral ingestion of 50 - 300 ml Lysoformin 3000 , a glutaral , glyoxal , and didecyl-dimethyl-ammoniumchloride containing disinfectant , caused severe coagulative necrosis in the upper gastrointestinal and whole respiratory tract in a 31 year old female . In the course of 86 days the injuries in the esophagus and stomach decreased almost entirely , while still ventilation and perfusion disorders in the respiratory system persisted . The mucosal injuries should lead to the change in the valuation of Lysoformin 3000 as corrosive to mucosal and dermal membranes ."
],
"offsets": [
[
0,
568
]
]
}
] |
[
{
"id": "IntensiveMedizin.80350281.eng.abstr-s1-t1",
"type": "umlsterm",
"text": [
"glutaral"
],
"offsets": [
[
54,
62
]
],
"normalized": [
{
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"db_id": "C0017814"
}
]
},
{
"id": "IntensiveMedizin.80350281.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"glyoxal"
],
"offsets": [
[
65,
72
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0017992"
}
]
},
{
"id": "IntensiveMedizin.80350281.eng.abstr-s1-t3",
"type": "umlsterm",
"text": [
"disinfectant"
],
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[
124,
136
]
],
"normalized": [
{
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"db_id": "C0012682"
}
]
},
{
"id": "IntensiveMedizin.80350281.eng.abstr-s1-t4",
"type": "umlsterm",
"text": [
"necrosis"
],
"offsets": [
[
165,
173
]
],
"normalized": [
{
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"db_id": "C0027540"
}
]
},
{
"id": "IntensiveMedizin.80350281.eng.abstr-s1-t5",
"type": "umlsterm",
"text": [
"old"
],
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[
245,
248
]
],
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{
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"db_id": "C0331059"
}
]
},
{
"id": "IntensiveMedizin.80350281.eng.abstr-s1-t6",
"type": "umlsterm",
"text": [
"female"
],
"offsets": [
[
249,
255
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0086287"
},
{
"db_name": "UMLS",
"db_id": "C0015780"
}
]
},
{
"id": "IntensiveMedizin.80350281.eng.abstr-s1-t7",
"type": "umlsterm",
"text": [
"respiratory tract"
],
"offsets": [
[
214,
231
]
],
"normalized": [
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"db_id": "C0282335"
}
]
},
{
"id": "IntensiveMedizin.80350281.eng.abstr-s2-t1",
"type": "umlsterm",
"text": [
"injuries"
],
"offsets": [
[
287,
295
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0175677"
},
{
"db_name": "UMLS",
"db_id": "C0021501"
}
]
},
{
"id": "IntensiveMedizin.80350281.eng.abstr-s2-t2",
"type": "umlsterm",
"text": [
"esophagus"
],
"offsets": [
[
303,
312
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0546837"
},
{
"db_name": "UMLS",
"db_id": "C0014876"
}
]
},
{
"id": "IntensiveMedizin.80350281.eng.abstr-s2-t3",
"type": "umlsterm",
"text": [
"stomach"
],
"offsets": [
[
317,
324
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0038351"
},
{
"db_name": "UMLS",
"db_id": "C0024623"
}
]
},
{
"id": "IntensiveMedizin.80350281.eng.abstr-s2-t4",
"type": "umlsterm",
"text": [
"ventilation"
],
"offsets": [
[
365,
376
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0042491"
},
{
"db_name": "UMLS",
"db_id": "C0035203"
}
]
},
{
"id": "IntensiveMedizin.80350281.eng.abstr-s2-t5",
"type": "umlsterm",
"text": [
"perfusion"
],
"offsets": [
[
381,
390
]
],
"normalized": [
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"db_id": "C0031001"
}
]
},
{
"id": "IntensiveMedizin.80350281.eng.abstr-s2-t6",
"type": "umlsterm",
"text": [
"disorders"
],
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391,
400
]
],
"normalized": [
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"db_id": "C0012634"
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]
},
{
"id": "IntensiveMedizin.80350281.eng.abstr-s2-t7",
"type": "umlsterm",
"text": [
"respiratory system"
],
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408,
426
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],
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"db_name": "UMLS",
"db_id": "C0035237"
}
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},
{
"id": "IntensiveMedizin.80350281.eng.abstr-s3-t1",
"type": "umlsterm",
"text": [
"injuries"
],
"offsets": [
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451,
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]
],
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{
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"db_id": "C0175677"
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"db_id": "C0021501"
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]
},
{
"id": "IntensiveMedizin.80350281.eng.abstr-s3-t2",
"type": "umlsterm",
"text": [
"corrosive"
],
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525,
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"db_id": "C0524525"
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},
{
"id": "IntensiveMedizin.80350281.eng.abstr-s3-t3",
"type": "umlsterm",
"text": [
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],
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"db_id": "C0025255"
}
]
},
{
"id": "IntensiveMedizin.80350281.eng.abstr-s3-t4",
"type": "umlsterm",
"text": [
"the change"
],
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475,
485
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0025320"
}
]
}
] |
[] |
[] |
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IntensiveMedizin.80350286.eng.abstr
|
IntensiveMedizin.80350286.eng.abstr
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"id": "IntensiveMedizin.80350286.eng.abstr-passage-0",
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],
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0,
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[] |
[] |
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"id": "IntensiveMedizin.80350286.eng.abstr-s1-r15-t4.1-t1.1",
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"arg2_id": "IntensiveMedizin.80350286.eng.abstr-s1-t1",
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IntensiveMedizin.80350307.eng.abstr
|
IntensiveMedizin.80350307.eng.abstr
|
[
{
"id": "IntensiveMedizin.80350307.eng.abstr-passage-0",
"type": "abstract",
"text": [
"There are two types of heparin-induced thrombozytopenia ( HIT ) : first the non-immunmediated , clinically inapparent HIT type I and second the immunmediated HIT type II which is associated with thromboembolic complications . The incidence of a HIT type I is about 25% . HIT type II occurs in about 3% of heparin-treated patients when heparin therapy is continued for more than 5 days . It is a disease which needs treatment in an intensive care unit and interdisciplinary co-operation . The mortality is about 20% and a further 20% of the patients suffer from permanent health damage such as limb-amputation , myocardial infarction or cerebral stroke . In most cases the antigen in HIT type II is a complex consisting of heparin and platelet factor 4 ( PF 4 ) , rarely a complex of heparin and a different protein . This complex of heparin and PF 4 binds to more than one antibody and forms immun-complexes which activate platelets by combining with the platelet Fc-receptor . Through repetitive platelet-activation followed by PF 4 sequestration , the resulting PF 4-overshoot combines with glucosaminoglycanes located on the surface on the endothelial cells . The HIT-antibody is not specific and combines also with complexes consisting of heparin and endothelial-standing glucoaminoglycanes . These immuncomplexes on the endothelial surface cause an immunmediated endothelial injury and lead to an increased thrombotic risk . Probably this is an important mechanism in the development of thromboembolic complications in HIT type II . Usually HIT type II occurs during the first exposition to heparin between the 6th and the 20th day of heparin-treatment , while during re-exposition to heparin it may re-occur within some hours . The platelet-count decreases beyond 100,000 µl. Typical signs are venous and arterial thromboembolic complications especially in the big venous vessels , limb arteries , cerebral arteries , and coronary vessels . Next to the typical clinical signs , evidence of HIT-antibodies is required for the diagnosis of a HIT type II . Established diagnostic methods are the heparin-induced platelet-activation- ( hipa- ) test and the immunoassay ( PF 4/heparin-ELISA). Lepirudin ( Refludan ) , a recombinant hirudin recently developed for the treatment of HIT type II shows an immediate action which can be easily monitored by the activated partial thromboplastin time ( aPTT ) . There is no risk of cross-reactivity to HIT-antibodies . To prevent a HIT type II it is important to check the platelet-count before initiation of heparin-therapy , and from the 5th day of heparin-treatment platelet-count should be checked daily . In case of re-exposition to heparin , platelet-count should be checked before and then daily during anticoagulation with heparin . Further , any unnecessary heparin-treatment should be avoided and if necessary it should be finished within 5 days . Oral anticoagulation with a dicumerol should be started as soon as possible . Patients who once suffered from a HIT type II should be given a rescue-certificate . These patients should not be treated with antithrombin III- or prothrombin-preparations because of the high heparin concentrations ."
],
"offsets": [
[
0,
3196
]
]
}
] |
[
{
"id": "IntensiveMedizin.80350307.eng.abstr-s1-t1",
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223
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"id": "IntensiveMedizin.80350307.eng.abstr-s2-t1",
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230,
239
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{
"id": "IntensiveMedizin.80350307.eng.abstr-s3-t2",
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"heparin"
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335,
342
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{
"id": "IntensiveMedizin.80350307.eng.abstr-s3-t3",
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343,
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"db_name": "UMLS",
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]
},
{
"id": "IntensiveMedizin.80350307.eng.abstr-s4-t1",
"type": "umlsterm",
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"disease"
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395,
402
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{
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424
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IntensiveMedizin.80350325.eng.abstr
|
IntensiveMedizin.80350325.eng.abstr
|
[
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],
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[
0,
125
]
]
}
] |
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]
}
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[] |
[] |
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"id": "IntensiveMedizin.80350325.eng.abstr-s1-r4-t1.1-t4.2",
"type": "issue_in",
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IntensiveMedizin.80350337.eng.abstr
|
IntensiveMedizin.80350337.eng.abstr
|
[
{
"id": "IntensiveMedizin.80350337.eng.abstr-passage-0",
"type": "abstract",
"text": [
"A 60 year old Greek woman was admitted because of fever , shivering , and suspicion of vaginal bleeding . Physical examination showed a seriously ill patient with pale and yellow color of the skin . The urine was dark-red . There was marked hemolytic anemia with hemoglobinuria . Further investigations revealed glucose-6-phosphate dehydrogenase deficiency with hemolysis after ingestion of fava beans three days prior to admission . Treatment consisted of forced diuresis , urine alkalinization , and erythrocyte transfusion . Because of self-limitation of the hemolytic anemia , the patient quickly recovered without complications . Mediterranean descent , ingestion of fava beans , and hemolytic crisis soon turned suspicion to inherited glucose-6-phosphate dehydrogenase deficiency . Information of the patient and her relatives about the genetic defect and hemolytic drugs or vegetables is necessary ."
],
"offsets": [
[
0,
906
]
]
}
] |
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{
"id": "IntensiveMedizin.80350337.eng.abstr-s1-t1",
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"old"
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10,
13
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"db_id": "C0331059"
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]
},
{
"id": "IntensiveMedizin.80350337.eng.abstr-s1-t2",
"type": "umlsterm",
"text": [
"woman"
],
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[
20,
25
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],
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"db_id": "C0043210"
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"id": "IntensiveMedizin.80350337.eng.abstr-s1-t3",
"type": "umlsterm",
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"fever"
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50,
55
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{
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"type": "umlsterm",
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"pale"
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167
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],
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"db_id": "C0030232"
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{
"id": "IntensiveMedizin.80350337.eng.abstr-s2-t3",
"type": "umlsterm",
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"color"
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184
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},
{
"id": "IntensiveMedizin.80350337.eng.abstr-s2-t4",
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"skin"
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196
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"id": "IntensiveMedizin.80350337.eng.abstr-s2-t5",
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"Physical examination"
],
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{
"id": "IntensiveMedizin.80350337.eng.abstr-s3-t1",
"type": "umlsterm",
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"urine"
],
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208
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],
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"db_id": "C0042036"
},
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"db_id": "C0042037"
}
]
},
{
"id": "IntensiveMedizin.80350337.eng.abstr-s4-t1",
"type": "umlsterm",
"text": [
"anemia"
],
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[
251,
257
]
],
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{
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"db_id": "C0002871"
}
]
},
{
"id": "IntensiveMedizin.80350337.eng.abstr-s4-t2",
"type": "umlsterm",
"text": [
"hemoglobinuria"
],
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[
263,
277
]
],
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"db_id": "C0019048"
}
]
},
{
"id": "IntensiveMedizin.80350337.eng.abstr-s4-t3",
"type": "umlsterm",
"text": [
"hemolytic anemia"
],
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[
241,
257
]
],
"normalized": [
{
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"db_id": "C0002878"
}
]
},
{
"id": "IntensiveMedizin.80350337.eng.abstr-s5-t1",
"type": "umlsterm",
"text": [
"dehydrogenase"
],
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332,
345
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],
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"db_id": "C0030016"
}
]
},
{
"id": "IntensiveMedizin.80350337.eng.abstr-s5-t2",
"type": "umlsterm",
"text": [
"deficiency"
],
"offsets": [
[
346,
356
]
],
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{
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"db_id": "C0011155"
}
]
},
{
"id": "IntensiveMedizin.80350337.eng.abstr-s5-t3",
"type": "umlsterm",
"text": [
"hemolysis"
],
"offsets": [
[
362,
371
]
],
"normalized": [
{
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"db_id": "C0019054"
}
]
},
{
"id": "IntensiveMedizin.80350337.eng.abstr-s5-t4",
"type": "umlsterm",
"text": [
"beans"
],
"offsets": [
[
396,
401
]
],
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"db_id": "C0004896"
}
]
},
{
"id": "IntensiveMedizin.80350337.eng.abstr-s5-t5",
"type": "umlsterm",
"text": [
"glucose-6-phosphate dehydrogenase deficiency"
],
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312,
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{
"id": "IntensiveMedizin.80350337.eng.abstr-s6-t1",
"type": "umlsterm",
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"Treatment"
],
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443
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"db_id": "C0039798"
}
]
},
{
"id": "IntensiveMedizin.80350337.eng.abstr-s6-t2",
"type": "umlsterm",
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"diuresis"
],
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]
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},
{
"id": "IntensiveMedizin.80350337.eng.abstr-s6-t3",
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],
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]
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]
},
{
"id": "IntensiveMedizin.80350337.eng.abstr-s6-t4",
"type": "umlsterm",
"text": [
"erythrocyte"
],
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502,
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],
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},
{
"id": "IntensiveMedizin.80350337.eng.abstr-s6-t5",
"type": "umlsterm",
"text": [
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],
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502,
525
]
],
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}
]
},
{
"id": "IntensiveMedizin.80350337.eng.abstr-s7-t1",
"type": "umlsterm",
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"self-limitation"
],
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539,
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]
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"db_id": "C0036588"
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{
"id": "IntensiveMedizin.80350337.eng.abstr-s7-t2",
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"text": [
"anemia"
],
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]
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{
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"type": "umlsterm",
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"id": "IntensiveMedizin.80350337.eng.abstr-s7-t4",
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]
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{
"id": "IntensiveMedizin.80350337.eng.abstr-s7-t5",
"type": "umlsterm",
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],
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{
"id": "IntensiveMedizin.80350337.eng.abstr-s8-t1",
"type": "umlsterm",
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"beans"
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{
"id": "IntensiveMedizin.80350337.eng.abstr-s8-t2",
"type": "umlsterm",
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"dehydrogenase"
],
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774
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"db_id": "C0030016"
}
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{
"id": "IntensiveMedizin.80350337.eng.abstr-s8-t3",
"type": "umlsterm",
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"id": "IntensiveMedizin.80350337.eng.abstr-s8-t4",
"type": "umlsterm",
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{
"id": "IntensiveMedizin.80350337.eng.abstr-s9-t2",
"type": "umlsterm",
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"db_id": "C0080103"
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},
{
"id": "IntensiveMedizin.80350337.eng.abstr-s9-t3",
"type": "umlsterm",
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{
"id": "IntensiveMedizin.80350337.eng.abstr-s9-t4",
"type": "umlsterm",
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],
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"db_id": "C0013227"
}
]
},
{
"id": "IntensiveMedizin.80350337.eng.abstr-s9-t5",
"type": "umlsterm",
"text": [
"vegetables"
],
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],
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"db_id": "C0042440"
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]
},
{
"id": "IntensiveMedizin.80350337.eng.abstr-s9-t6",
"type": "umlsterm",
"text": [
"genetic defect"
],
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[
843,
857
]
],
"normalized": [
{
"db_name": "UMLS",
"db_id": "C0017384"
}
]
}
] |
[] |
[] |
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] |
IntensiveMedizin.80350349.eng.abstr
|
IntensiveMedizin.80350349.eng.abstr
|
[
{
"id": "IntensiveMedizin.80350349.eng.abstr-passage-0",
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"The last two decades have seen a marked change in the role of plasmapheresis in the intensive care unit ( ICU ) . Initially regarded as highly effective in treating virtually any immunological disease , insights in pathophysiology and results from controlled trials have left only a few indications validated . To date , plasmapheresis is indicated for acute treatment of severe immunological disorders either unresponsive to immunosuppression or requiring large volumes of human plasma for therapy . In the future , more specific and less cumbersome methods of immunosuppression and immunomodulation might further limit indications of plasmapheresis . In this review , current indications and side-effects of plasmapheresis in the ICU setting are summarized ."
],
"offsets": [
[
0,
760
]
]
}
] |
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"id": "IntensiveMedizin.80350349.eng.abstr-s3-t7",
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[] |
[] |
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] |
IntensiveMedizin.80350375.eng.abstr
|
IntensiveMedizin.80350375.eng.abstr
|
[
{
"id": "IntensiveMedizin.80350375.eng.abstr-passage-0",
"type": "abstract",
"text": [
"To prevent nosocomial pneumonia in the postoperative setting , it is important to take into account the endogenous risk factors in the preoperative and postoperative phase . This includes optimal drug therapy of an obstructive lung disease , respiratory therapy in the preoperative phase , use of an incentive spirometer or intermittent positive pressure breathing on patients at high risk of developing pneumonia in the postoperative phase , and instructing preoperative patients to stop smoking . Further measures are optimising the treatment of other predisposing diseases and the nutritional status , appropriate analgesic drug therapy in patients with postoperative pain during breathing , prefering nonsedative analgesic drugs , early mobilization , and withdrawal or reduction of immunsuppressive drugs in the preoperative and postoperative setting if not contraindicated . The preoperative phase of treatment should be managed in an ambulant setting , which is superior to hospitalization with respect to the nosocomial infection rate . There is also a positive correlation of the duration of postoperative hospital stay and the rate of postoperative nosocomial pneumonia . Thus , patients should not be hospitalized longer than necessary . Predisposing exogenous risk factors such as enteral feeding tubings should be replaced as soon as possible . Beside this , basic care and standard good quality hygienic measures are important in preventing postoperative pneumonia ."
],
"offsets": [
[
0,
1480
]
]
}
] |
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