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Search Results: 1 - 10 of 467828 matches for " Carmen A. Pfortmueller "
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Injuries, Sequelae, and Treatment of Lightning-Induced Injuries: 10 Years of Experience at a Swiss Trauma Center
Carmen A. Pfortmueller,Yang Yikun,Monika Haberkern,Erwin Wuest,Heinz Zimmermann,Aristomenis K. Exadaktylos
Emergency Medicine International , 2012, DOI: 10.1155/2012/167698
Abstract: Principals. Lightning is one of the most powerful and spectacular natural phenomena. Lightning strikes to humans are uncommon but can cause devastating injuries. We analyzed lightning-related admissions to our emergency department from January 2000 to December 2010 to review and highlight the main features of lightning-related injuries. Methods. All data were collected prospectively and entered in the emergency department’ database (Qualicare Switzerland) and retrospectively analyzed. Results. Nine patients with lightning-related injuries presented to our emergency department. Four were female, and five were male. The most common site of injury was the nervous system (6 out of 9 patients) followed by the cardiovascular system (5 out of 9 patients). The third most common injuries occurred to the skin (3 out of 9 patients). Four of the patients had to be hospitalized for further observation. Conclusion. Reports of lightning strikes and related injuries are scarce. The establishment of an international register would therefore benefit the understanding of their injury patterns and facilitate specific treatment. 1. Introduction Lightning is one of the most powerful and spectacular natural phenomena [1]. It is the transfer of electrical charges between clouds or between the ground and clouds and occurs when a difference in potential of 30,000?V or higher exceeds the inherent resistance of the air [2]. Lightning strikes the earth more than 8 million times per day [3]. It is the second leading cause of weather-related death after flooding [4–6]. The risk of being struck by lightning is dependent on regional, seasonal and temporal factors [5, 7–9]. Lightning injuries peak during the summer months throughout the world [5, 7]. Most lightning accidents occur outdoors [10]. People involved in golfing, fishing, swimming, boating, camping, or hiking are particularly at risk [10]. Reviews of lightning injuries have, however, found that one-third or more occur indoors [9, 11]. As an injury mechanism, it is postulated that if lightning strikes a house, for example, the electrical energy can be transmitted through plumbing fixtures such as sinks, showers, or toilets [11]. According to a review by Lederer et al., about 10% of lightning injures occur during transport in motor vehicles [2]. Men are generally at greater risk of suffering lightning strikes than women [2, 4, 10, 12]. In reviews, a male?:?female ratio of 5?:?1 was found [7, 11]. Lightning strikes in humans are an uncommon but potentially devastating cause of injury [5, 13, 14]. In contrast to other high-voltage
Multimorbidity in Adult Asylum Seekers: A First Overview
Carmen A. Pfortmueller, Manuela Stotz, Gregor Lindner, Thomas Müller, Nicolas Rodondi, Aristomenis K. Exadaktylos
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0082671
Abstract: Principals Over the last two decades, the total annual number of applications for asylum in the countries of the European Union has increased from 15,000 to more than 300,000 people. The aim of this study was to give a first overview on multimorbidity of adult asylum seekers. Methods Our retrospective Swiss single center data analysis examined multimorbidity of adult asylums seekers admitted to our ED between 1 January 2000 and 31 December 2012. Results A total of 3170 patients were eligible for the study; they were predominantly male (2392 male, 75.5% versus 778 female, 24.5). The median age of the patients was 28 years (range 28–82). The most common region of origin was Africa (1544, 48.7%), followed by the Middle East (736, 23.6%). 2144 (67.6%) of all patients were not multimorbid. A total of 1183 (37.7%) of our patients were multimorbid. The mean Charlson comorbidity index was 0.25 (SD 1.1, range 0–12). 634 (20%) of all patients sufferem from psychiatric diseases, followed by chronic medical conditions (12.6%, 399) and infectious diseases (4.7%, 150). Overall, 11% (349) of our patients presented as a direct consequence of prior violence. Patients from Sri Lanka/India most often suffered from addictions problems (50/240, 20.8%, p<0.0001). Infectious diseases were most frequent in patients from Africa (6.6%), followed by the Balkans and Eastern Europe/Russia (each 3.8%). Conclusion The health care problems of asylum seekers are manifold. More than 60% of the study population assessed in our study did not suffer from more than one disease. Nevertheless a significant percentage of asylum seekers is multimorbid and exhibits underlying psychiatric, infectious or chronic medical conditions despite their young age.
Injury Severity and Mortality of Adult Zebra Crosswalk and Non-Zebra Crosswalk Road Crossing Accidents: A Cross-Sectional Analysis
Carmen A. Pfortmueller, Mariana Marti, Mirco Kunz, Gregor Lindner, Aristomenis K. Exadaktylos
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0090835
Abstract: Principals Over a million people worldwide die each year from road traffic injuries and more than 10 million sustain permanent disabilities. Many of these victims are pedestrians. The present retrospective study analyzes the severity and mortality of injuries suffered by adult pedestrians, depending on whether they used a zebra crosswalk. Methods Our retrospective data analysis covered adult patients admitted to our emergency department (ED) between 1 January 2000 and 31 December 2012 after being hit by a vehicle while crossing the road as a pedestrian. Patients were identified by using a string term. Medical, police and ambulance records were reviewed for data extraction. Results A total of 347 patients were eligible for study inclusion. Two hundred and three (203; 58.5%) patients were on a zebra crosswalk and 144 (41.5%) were not. The mean ISS (injury Severity Score) was 12.1 (SD 14.7, range 1-75). The vehicles were faster in non-zebra crosswalk accidents (47.7 km/n, versus 41.4 km/h, p<0.027). The mean ISS score was higher in patients with non-zebra crosswalk accidents; 14.4 (SD 16.5, range 1–75) versus 10.5 (SD13.14, range 1–75) (p<0.019). Zebra crosswalk accidents were associated with less risk of severe injury (OR 0.61, 95% CI 0.38–0.98, p<0.042). Accidents involving a truck were associated with increased risk of severe injury (OR 3.53, 95%CI 1.21–10.26, p<0.02). Conclusion Accidents on zebra crosswalks are more common than those not on zebra crosswalks. The injury severity of non-zebra crosswalk accidents is significantly higher than in patients with zebra crosswalk accidents. Accidents involving large vehicles are associated with increased risk of severe injury. Further prospective studies are needed, with detailed assessment of motor vehicle types and speed.
High-Sensitive Troponin Measurement in Emergency Department Patients Presenting with Syncope: A Retrospective Analysis
Gregor Lindner, Carmen A. Pfortmueller, Georg-Christian Funk, Alexander B. Leichtle, Georg Martin Fiedler, Aristomenis K. Exadaktylos
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0066470
Abstract: Objective To study the relevance of high-sensitive troponin measurements in the acute workup in patients admitted to the emergency department of a large university hospital due to syncope. Methods In this retrospective study all patients admitted to the emergency department because of syncope of the Inselspital, University Hospital Bern between 01 August 2010 and 31 October 2012, with serial determination of high-sensitive troponin (baseline and three hours control) were included. Of all identified patients we obtained data on demographics, laboratory data, ECG as well as on outcome. A change in high-sensitive troponin in the three hours control of +/?30% compared to baseline was considered significant. Results A total of 121 patients with a mean age of 67 years (SD 16) were included in the study. 79 patients (65%) were male and 42 (35%) were female. There was no significant difference in the median high sensitive-troponin level at baseline and in the three hours control (0.01 mcg/L [0.003 to 0.022] versus 0.011 mcg/L [0.003 to 0.022], p = 0.47). Median percent change in high-sensitive troponin level between baseline and control was 0% (?9.1 to 5). 51 patients (42%) had elevated high-sensitive troponin levels at baseline with 7 patients (6%) showing a dynamic of +/?30% change from the baseline measurement in the 3 hours control. 3 of these patients received coronary angiography due to the dynamic in high-sensitive troponin, none of whom needed intervention for coronary revascularization. Conclusions On basis of the current study, where no single patient took benefit from determination of high-sensitive troponin, measurement of cardiac troponins should be reserved for patients with syncope presenting with symptoms suggestive for the presence of an acute cardiac syndrome.
Electrolyte Disorders and In-Hospital Mortality during Prolonged Heat Periods: A Cross-Sectional Analysis
Carmen A. Pfortmueller, Georg-Christian Funk, Alexander B. Leichtle, Georg M. Fiedler, Christoph Schwarz, Aristomenis K. Exadaktylos, Gregor Lindner
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0092150
Abstract: Background Heat periods during recent years were associated with excess hospitalization and mortality rates, especially in the elderly. We intended to study whether prolonged warmth/heat periods are associated with an increased prevalence of disorders of serum sodium and potassium and an increased hospital mortality. Methods In this cross-sectional analysis all patients admitted to the Department of Emergency Medicine of a large tertiary care facility between January 2009 and December 2010 with measurements of serum sodium were included. Demographic data along with detailed data on diuretic medication, length of hospital stay and hospital mortality were obtained for all patients. Data on daily temperatures (maximum, mean, minimum) and humidity were retrieved by Meteo Swiss. Results A total of 22.239 patients were included in the study. 5 periods with a temperature exceeding 25°C for 3 to 5 days were noticed and 2 periods with temperatures exceeding 25°C for more than 5 days were noted. Additionally, 2 periods with 3 to 5 days with daily temperatures exceeding 30°C were noted during the study period. We found a significantly increased prevalence of hyponatremia during heat periods. However, in the Cox regression analysis, prolonged heat was not associated with the prevalence of disorders of serum sodium or potassium. Admission during a heat period was an independent predictor for hospital mortality. Conclusions Although we found an increased prevalence of hyponatremia during heat periods, no convincing connection could be found for hypernatremia or disorders of serum potassium.
Image and Imaging an Emergency Department: Expense and Benefit of Different Quality Assessment Methods
Carmen Andrea Pfortmueller,Michael Keller,Urs Mueller,Heinz Zimmermann,Aristomenis Konstantinos Exadaktylos
Emergency Medicine International , 2013, DOI: 10.1155/2013/213263
Abstract: Introduction. In this era of high-tech medicine, it is becoming increasingly important to assess patient satisfaction. There are several methods to do so, but these differ greatly in terms of cost, time, and labour and external validity. The aim of this study is to describe and compare the structure and implementation of different methods to assess the satisfaction of patients in an emergency department. Methods. The structure and implementation of the different methods to assess patient satisfaction were evaluated on the basis of a 90-minute standardised interview. Results. We identified a total of six different methods in six different hospitals. The average number of patients assessed was 5012, with a range from 230 (M5) to 20 000 patients (M2). In four methods (M1, M3, M5, and M6), the questionnaire was composed by a specialised external institute. In two methods, the questionnaire was created by the hospital itself (M2, M4).The median response rate was 58.4% (range 9–97.8%). With a reminder, the response rate increased by 60% (M3). Conclusion. The ideal method to assess patient satisfaction in the emergency department setting is to use a patient-based, in-emergency department-based assessment of patient satisfaction, planned and guided by expert personnel. 1. Introduction In recent decades, there have been major technical improvements in the health systems of western countries [1]. In this era of high technology, patient satisfaction has become increasingly important [1, 2]. Since the 1950s, patient satisfaction has had an important role in the evaluation of medical care [2]. There are various reasons why it may be profitable for a hospital to perform surveys on patient satisfaction [3]. Several studies have found that satisfied patients suffer less pain [4, 5]; they require fewer (secondary) operations and more rarely have complications [4, 5]. Moreover, satisfied patients exhibit better compliance [4–6]. This simplifies therapy and enhances treatment efficiency [6]. There are also reports that satisfied patients stay for up to 50% less time in hospitals [1, 4, 7]. On the other hand, patient dissatisfaction is a decisive reason for complaints after leaving the hospital [8] as well as for litigation [5, 9]. Thus, an improvement in patient satisfaction can make a major contribution to cost reduction and to maintaining competitiveness [3]. Performing surveys on patient satisfaction is, therefore, an essential patient-centred improvement process [10]. A very wide variety of methods are now in use to assess patient satisfaction with some drastic
Comparation of the eutectic mixture of lidocaine/prilocain versus benzocaine gel in children  [PDF]
Ana María Leyda, Carmen Llena
Open Journal of Stomatology (OJST) , 2011, DOI: 10.4236/ojst.2011.13014
Abstract: Objective: To compare the anesthetic effect of a non commercial eutectic mixture of 4% lidocaine/ prilocaine (PLO 4%) and 20% benzocaine gel (Hurricaine®), as topical anesthetic, prior to inferior alveolar nerve block and buccal infiltration anesthe-sia in 5-12 year old children. Study design: Infiltrative anesthesia was applied in 50 children, divided in two groups (n = 25) using PLO 4% and Hurricaine® as topical anesthesia prior to infiltration. Physical reac-tions were registered using the Sound-Eyes- Motor Scale. Physiological changes expressed by ar-terial pressure and heart rate. Subjective pain re-sponse was scored on a Facial Image Scale. Physical physiological and subjective response was related to the type of topical anesthetic, age and sex using χ2 and Mann-Whitney U test. Results: Physical responses to puncture were similar and localized in the state of comfort with both anesthetics. Girls showed more ocular response than boys. Subjective pain perception and physiological reactions showed no anesthetic- or sex-related differences, except for heart rate before and after the procedure which was significantly higher in girls. Conclusions: PLO 4% showed the same capacity as Hurricaine® in reducing pain response to needle puncture. Girls expressed more needle puncture-related pain than boys. The young children showed most prior comfort and less discomfort to the puncture than older children.
Morfología del esporófito y el gametófito de Asplenium dareoides (Aspleniaceae, Pteridophyta)
Lavalle,María del Carmen; Prada,Carmen;
Darwiniana , 2007,
Abstract: sporophyte morphology of asplenium dareoides was reviewed, and development and morphology of its gamethophytes were studied for the first time from spore culture on mineral agar. spores germinated 10 days after sown, and cultures reached a low percentage of germination (1 to 5%). filamentous phase was initiated at 15 days. gametophytes followed the aspidium type of development, which leads to a hairy adult state, with cylindrical, marginal and superficial hairs. the morphological study of the sporophyte was based on foliar architecture, indument, epidermal patterns of pinnulae and indusium, spore size (mean values between 28.9 and 39.7 μm) and spore morphology. gametic chromosome number found was n = 72. morphological and palynological characters of a. dareoides do not support the close relationship with a. flabellifolium, recently suggested from molecular data.
Morfología del esporófito y el Gametófito de Asplenium dareoides (Aspleniaceae, Pteridophyta)
María del Carmen Lavalle,Carmen Prada
Darwiniana , 2007,
Abstract: Se revisó la morfología del esporófito y se estudió por primera vez el desarrollo y la morfología del gametófito de Asplenium dareoides, a partir de esporas cultivadas en un medio nutritivo solidificado con agar. Las esporas germinaron a partir de los 10 días en un porcentaje muy bajo (1 al 5%). La fase filamentosa se inició a los 15 días. Los gametófitos siguieron un modelo de desarrollo de tipo Aspidium, y en la madurez presentaron pelos marginales y superficiales, cilíndricos y algo ensanchados en el ápice. El estudio morfológico del esporófito se basó en la arquitectura foliar, el indumento, el modelo epidérmico de las pínnulas y de los indusios, y en la morfología y el tama o de las esporas (longitud media de 28,9 a 39,7 μm). El estudio de la meiosis arrojó un número cromosómico gamético n = 72. Los caracteres morfológicos externos y palinológicos de A. dareoides no reflejan su parentesco con A. flabellifolium, recientemente sugerido sobre la base de caracteres moleculares.
Isolation, Partial Purification and Characterization of Texas Live Oak (Quercus fusiformis) Lectin  [PDF]
Ruby A. Ynalvez, Carmen G. Cruz, Marcus A. Ynalvez
Advances in Bioscience and Biotechnology (ABB) , 2015, DOI: 10.4236/abb.2015.67049
Abstract: Lectins are carbohydrate-binding proteins with agglutination properties. There is a continuous interest in lectins due to their biological properties that can be exploited for medicinal and therapeutic purposes. The objective of this study was to isolate and characterize lectin activity in Texas Live Oak (Quercus fusiformis). More specifically, the study aimed to determine the lectin’s blood group specificity and pH stability, determine effects of seasonal variation, soil moisture and soil pH on lectin activity. The study also aimed to determine the presence of antifungal activity in Q. fusiformis extracts. Lectin activity was detected and compared via agglutination and protein assays. Protein partial purification was accomplished using diethylaminoethyl ion-exchange chromatography matrix. High Performance Liquid Chromatography (HPLC) was used to assess purity of the lectin. Results showed that Q. fusiformis extracts’ lectin activities are stable at a pH range of 5.2 - 9.2 but with a significant decrease in activity above pH 9.2. The lectin activity was significantly higher when assayed against sheep red blood cells as compared to other blood groups tested. Quercus fusiformis extract is devoid of antifungal activity against Aspergillus niger and Rhizopus stolonifer. The effects of seasonal variation, soil moisture and soil pH do not significantly correlate with lectin activity. Results from HPLC showed presence of three peaks indicating a partial purification of the Q. fusiformis lectin.
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