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To date microscopy and cultural isolation still remain the “gold standard” in the laboratory diagnostics of mycobacteria. Nucleic acid amplification techniques additionally enable a rapid and sensitive detection of Mycobacterium tuberculosis. However, bacterial growth is still required for species identification and susceptibility testing which should be performed from one of the first isolates of every patient and repeated after about 2 months if cultures are still positive. By means of DNA fingerprint techniques, the confirmation of transmission, of TB outbreaks, and also of laboratory cross-contamination is feasible. 相似文献
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Ohne Zusammenfassung 相似文献
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Stellenwert von inhaliertem Stickstoffmonoxid bei der Behandlung des schweren akuten Lungenversagens
H. Lohbrunner M. Deja T. Busch C. D. Spies R. Rossaint Prof. Dr. U. Kaisers 《Der Anaesthesist》2004,53(8):771-784
Acute respiratory distress syndrome (ARDS) is characterized by perfusion in favor of non-ventilated areas of the lungs as the main cause of intrapulmonary right-to-left shunt and hypoxemia. Therapeutic interventions to selectively influence pulmonary perfusion in ARDS became possible with the introduction of inhaled nitric oxide (iNO), which provided a way not only to reduce pulmonary hypertension, but also to acutely improve ventilation-perfusion mismatch, and thus to treat severe hypoxemia. Clinical studies in ARDS demonstrated that the combination of iNO with other interventions, such as positive end-expiratory pressure (PEEP) and prone positioning, yielded beneficial and additive effects on arterial oxygenation. Although randomized controlled trials of this concept have up to now failed to show an improved outcome, iNO is a valuable option for the treatment of severe refractory hypoxemia in ARDS patients. 相似文献
969.
Chronic lymphocytic leukemia of the B-cell type (B-CLL) is the most common type of leukemia in the western hemisphere. Concepts of pathogenesis, diagnostic procedures and therapy of CLL have changed tremendously over the past 15 years. These developments have called for a reassessment of therapeutic goals and clinical management, particularly of physically fit patients without relevant comorbidity. Since purine analogous and humanized antibodies were introduced into CLL therapy, longer lasting remissions become achievable. With the introduction of allogeneic stem cell transplantation, first curative approaches are available now have become available. New diagnostic tools improved risk stratification in CLL patients facilitating the implementation of risk-adapted therapeutic strategies. New therapeutic options are being evaluated within study protocols by the German CLL Study Group (GCLLSG). The aim of these studies is to optimize CLL therapy continuously by the comorbidity, stage and risk-adapted use of different treatment modalities. 相似文献
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