[Dysphagia after taking an acetaminophen-tablet during oral anticoagulation]. / Dysphagie nach Einnahme einer Paracetamoltablette unter oraler Antikoagulation.

The bezoar is only one example for an urgent indication for endoscopic intervention during oral anticoagulation. Because of the lack of life-threatening indication the endoscopy often is delayed for 1 to 3 days until the International Normalized Ratio (INR) is nearly in normal range. As well as the application of unique guidelines on endoscopy during oral anticoagulation new future oral anticoagulants with lower half-life may help to shorten suffering of patients.

Networking, coping, and communicating about a medical crisis: a phenomenological inquiry of transplant recipient communication.

Through a phenomenological framework, the authors attempt to shed light on the communication processes of organ transplant recipients when discussing transplantation and related topics. Eight essential themes (awareness, support, commitment, pride, education, mentoring, comparison, and community) emerged from 37 participants as central to the communicative experiences of transplant recipients and their families. Additional insight was generated through a 2nd tier of focus group discussions resulting in a proposed model of transplant recipient communication. An interpretation of the model, implications for future research, and implications for praxis are presented.

The use of composite dust wipe samples as a means of assessing lead exposure.

This study investigated two methods for analyzing composite dust wipes for lead. The term composite means two or more wipes collected from common components in a dwelling that are combined in the field and analyzed as a single sample. Two methods--a modified Environmental Protection Agency (EPA) Method 3050A and a Wisconsin Occupational Health Laboratory (WOHL) method--were selected based on their anticipated ability to handle the added mass of materials and dust expected in a composite. The study used off-the-shelf wipes to prepare single-, two-, and four-wipe samples. Wipes were spiked with a standard reference material at either a low dust loading level or a high level, and three laboratories analyzed the samples using both methods and both flame atomic absorption spectrometry and inductively coupled plasma-atomic emission spectrometry techniques (ICP). Good agreement with known spiked levels was possible using either method; the modified EPA 3050A showed particular promise. When up to four wipes were combined, all three laboratories found that modified EPA Method 3050A resulted in recoveries between 89 and 101% of the known standard. Although it was possible to achieve good agreement with spiked levels using the WOHL method, some difficulties were encountered, particularly when followed by ICP analysis and when using four wipes. The increased time required to digest the multiwipe composites was not proportional to the number of wipes in a composite: the two- and four-wipe composites did not take two to four times as long as a single-wipe sample. Laboratory analysis of a four-wipe sample cost an average of 65% less than analysis of four single-wipe samples for each method.

Bilateral cortical blindness: an unusual presentation of bacterial endocarditis.

We report the case of a 37-year-old woman who presented to the emergency department with the initial complaint of complete blindness. The patient was found to have bilateral ruptured occipital mycotic aneurysms as a sequela of bacterial endocarditis. This case is unique in several aspects. Although blindness may be a presenting neurologic symptom, it is exceedingly rare. To our knowledge, bilateral cortical blindness secondary to mycotic aneurysm rupture has not been reported previously.

Experimental determination of cascade parameters of a hearing-aid microphone via the two-load method.

Presented in this article is a computer-aided experimental method for obtaining the cascade parameters of the two-port model of a miniature hearing-aid microphone. The method is an adaptation of the "two-load" method [D.P. Egolf and R.G. Leonard, J. Acoust. Soc. Am. 62, 1013-1023 (1977)] to acoustoelectric, rather than electroacoustic, transducers. The cascade parameters of a particular microphone, determined by this method, were within 2.5 dB of the manufacturer's published open-circuit sensitivity data. In an attempt to further verify the numerical cascade-parameter data, a two-port model of the microphone was used to simulate experimental voltages developed across two different complex electrical load impedances attached to the microphone. The results showed experimental/simulation differences of no greater than 3.0 dB at any frequency. The two-port microphone model and associated cascade parameters are currently being incorporated into a computer-based plan for mathematical simulation of an entire in situ hearing aid.

[Clinical study with Spectacillin on patients with infections of the urogenital system (author's transl)]. / Klinische Untersuchungen mit Spectacillin bei Infektionen des Urogenitalsystems

Report is given of clinical experiences gained with the new developed semi-syntheticpenicillin "Spectacillin" on 75 patients suffering from an urological disease. The drug has been applied for therapy of acute and chronic forms of inflammations of the bladder and the urethra, additionally the prostatitis, the epididymitis, but first of all the pyelonephritis (caused bacterially). Within the germ spectrum of these diseases, germs of the coli-type, streptococcus faecalis (enterococcus), staphylococcus aureus, Neisseria gonorrhoeae, proteus, pseudomonas and aerobacter were found. Patients with acute/subacute diseases have been treated 8 to 9 days (3-4 grams per day) on an average; in case of chronic diseases, the patients received initially 1 gram a day and thereupon during 3 to 4 weeks 3 to 4 grams per day. The well-succeeded results have been documentated by means of the clinical course, the germ-elimination and the laboratory findings. The exanthematous quote may be demonstrated as remarkably low, considering the good universal compatibility of the substance. For this reason "Spectacillin" not finally is suitable for treatment of acute and chronic infections of the urogenital systems.