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  • 1
    Electronic Resource
    Electronic Resource
    Primary aldosteronism: difference in clinical presentation and long-term follow-up between adenoma and bilateral hyperplasia of the adrenal glands (1994)
    Springer
    Journal of molecular medicine 72 (1994), S. 979-984 
    Details
    ISSN: 1432-1440
    Keywords: Adenoma ; Aldosterone ; Adrenalectomy ; Gynecomastia ; Hyperaldosteronism ; Hyperplasia ; Spironolactone
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Since 1974 primary aldosteronism has been diagnosed in 71 patients in our outpatient clinic. Thirty-four patients had a unilateral aldosterone-producing adenoma, whereas bilateral adrenal hyperplasia was diagnosed in 37 patients. Although at the time of diagnosis the mean potassium values were lower and mean aldosterone levels were higher in patients with an adenoma, as compared to those with bilateral hyperplasia, these laboratory data did not allow us to differentiate between the two leading causes of primary aldosteronism in the individual patient due to pronounced overlap of laboratory values between the two groups. During the first few years, a successful differential diagnosis was made by adrenal phlebography and separate sampling of plasma aldosterone in both adrenal veins; later non-invasive imaging techniques such as computed tomography and radionuclide scanning were used. The best results were obtained in patients with adenoma who underwent adrenalectomy. Fifty-six percent of these patients were clinically and biochemically cured; 28% were improved and had normal blood pressure values during drug treatment. In contrast, patients with bilateral hyperplasia were treated pharmacologically, but only in half of the patients could normal blood pressure values be achieved. Two thirds of the male patients developed gynecomastia during spironolactone treatment. As expected, unilateral adrenalectomy was unsuccessful in the 7 patients with bilateral hyperplasia who underwent surgery. Our results confirm that surgical treatment of adrenal adenomas and drug treatment of bilateral hyperplasias are the appropriate therapy in primary aldosteronism. A differential diagnosis cannot be made on the basis of clinical and non-invasive laboratory data alone; imaging techniques have to be included in the diagnostic process. The long-term clinical outcome was more favorable in patients with an adrenal adenoma that can be removed surgically than in patients with idiopathic hyperplasia of both adrenal glands.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00577740
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Das NAWdat-Projekt (2000)
    Springer
    Notfall + Rettungsmedizin 3 (2000), S. 511-520 
    Details
    ISSN: 1436-0578
    Keywords: Schlüsselwörter Notfallmedizin ; DIVI-Notarzteinsatzprotokoll ; Elektronische Dokumentation ; Qualitätsmanagement ; NAWdat-Projekt ; Keywords Out-hospital emergency care ; Electronic documentation ; Quality management ; Emergency professionals
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract With the help of the NAWdat-project numerous emergency departments in Germany introduced an electronic documentation-system for out-hospital emergency doctors. These electronic records were linked to a database on 15.614 emergency cases documented by 172 doctors. Analysing these data gives an interesting insight into the work of German out-hospital emergency professionals.
    Notes: Zusammenfassung Mit Hilfe des NAWdat-Projektes wurde an zahlreichen Notarztstandorten eine elektronische Einsatzdokumentation eingeführt. Im Rahmen dieses Projektes erfolgte nun die Zusammenführung von 15.614 Einsatzdokumentationen, die von 172 Notärztinnen und Notärzten aus unterschiedlichen Teilen Deutschlands dokumentiert worden sind. Die Auswertung dieses Datenmaterials in Form einer Bestandsaufnahme erlaubt einen weitgehend realitätsnahen Einblick in das alltägliche Handeln der deutschen Notärzte.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s100490070004
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    Paper (German National Licenses)
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