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Ohne ZusammenfassungMit 5 AbbildungenMit Unterstützung der Deutschen Forschungsgemeinschaft.  相似文献   

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Adams HA 《Der Anaesthesist》2007,56(4):371-379
Hypovolemic shock is not a form of disease and can be subdivided into four special types with varying therapeutic demands. The decisive approach in the therapy of hypovolemic shock is to initially attain normovolemia by rapid administration of volume replacement agents in the sense of controlled hemodilution. This allows an adequate increase in the cardiac output resulting in delivery of sufficient oxygen to tissues. In the following article the limits of intervention will be described and the advantages and disadvantages of these measures for patients suffering from hypovolemic shock will be critically considered.  相似文献   

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Zusammenfassung Nach einer aktiven Korrosion finden sich im metallotischen Gewebe immer kompakte Legierungsbestandteile und deren Abbauprodukte. Die Metallosen sind auf die Umgebung der aktivierten Stellen begrenzt. Die Abbauprodukte der V4A-Legierungen zeigen eine geringere Toxicität als diejenigen der Co-Legierungen.Die dauernde Korrosion der Passivschicht führt zu einer Gleichgewichtskonzentration der Legierungselemente, welche zwischen einigen ppm und 150 ppm der Trockensubstanz variiert. Der Einfluß dieses Metallionenstroms, durch den Körper zu den Ausscheidungsorganen, auf die Stoffwechselvorgänge ist ungeklärt. Der moderne V4A-Stahl weist für die Ziele der operativen Frakturbehandlung entscheidende Vorteile auf, und zwar in Hinsicht auf die Festigkeitseigenschaften, die gute Verarbeitbarkeit und die geringe Toxicität der Korrosionsprodukte. Der örtliche Zusammenbruch der Passivität läßt sich hauptsächlich durch eine richtige Handhabung der Implantate vermeiden.Mit 5 AbbildungenDie Arbeit erfolgte im Rahmen der Arbeitsgemeinschaft für Osteosynthesefragen.Vortragender:F. Straumann-Waldenburg.  相似文献   

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Due to the higher incidence of malignant tumours with increasing age, cancer is the second most common cause of death among those aged over 65 years old. Consequently, demographic changes in Germany have resulted in a rising demand for oncological operations in elderly patients which is more cost-intensive. Objective of the present study in the setting of a university surgical department is whether oncological operations on patients over 80 years old is cost-effective in the era of diagnosis-related groups. The revenue and expenditure of 116 cases of patients over 80 years old documented for the years 2005–2007 were collated and evaluated. The calculated average proceeds were compared with cases of patients under 80 years old. The average return was ?1493.50 EUR/case for over 80-year olds and was not cost-effective. The presence or absence of complications had a significant impact on proceeds, because the mean return/case without complications was profitable (1297.30 EUR). Medical care of patients over 80 years old was on average cost-effective and generated a profit. Oncological operations in patients under 80 years old were not sufficiently remunerated by the current DRG system. Therefore, there is an economical risk associated with oncological operations in elderly patients.  相似文献   

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Thieme K 《Der Orthop?de》2004,33(5):576-582
This contribution presents the psychosocial, psychopathological, psycho- and elektrophysiological as well as endocrine results in the aetiopathogenesis of fibromyalgia syndrome (FMS). Three subgroups could be differentiated based on psychosocial learning processes. They differ in pain intensity and interference, affective distress, activity and spouse responses. They influence pain behavior and CNS activity in the sense of operant conditioning. The relationship between dysregulated pain modulation in the CNS and endocrine dysregulation of the HPA-axis, which seems to be relevant for the autonome hyporeaction of muscle and blood pressure, are discussed. The "dynamic processing model for FMS" is presented.  相似文献   

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