[Heparin and monitoring of peroral anticoagulant therapy].
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Administration, Oral↗
Biomedical subjects
A Bremmelgaard
Publications and source records attributed to A Bremmelgaard.
Eight cases of Capnocytophaga infections in Denmark.
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Adolescent↗
Effect of culture medium and carbon dioxide concentration on growth of anaerobic bacteria and medium pH.
Two Danish agars, Danish Blood Agar (D.B.A.) and Anaerobic Agar (A.A.), were evaluated for their ability to support growth of 47 clinically isolated anaerobic strains in 5 different CO2-concentrations ranging from 0-10% CO2. CO2 and the use of an enriched medium (A.A.) are essential for satisfactory recovery of anaerobes. No gain could be seen when raising the CO2-concentration above 5%. The surface pH of the agars was measured both on non-inoculated and inoculated plates at room temperature and anaerobic incubation in the 5 different CO2-concentrations at 37 degrees C. Temperature change from room temperature to 37 degrees C resulted in a pH decrease of 0.1 units. There was a CO2-mediated decrease in pH (approximately 0.05 units/pr. CO2%) on non-inoculated media. On inoculated plates there was a minor additional fall in pH, which increased with time of incubation, but first became significant when the plates were incubated for more than 24 h. The use of 5% CO2 and A.A. is recommended for antimicrobial susceptibility studies on solid media.
Bacteria, Anaerobic↗
Continuous ambulatory peritoneal dialysis: microbiological diagnosis in peritonitis.
Dialysate samples from 29 Continuous Ambulatory Peritoneal Patients (CAPD)-patients were taken in periods with and without peritonitis and cultured simultaneously in the Hemobact system and on conventional plate media, using a standard technique. Bacteria were demonstrated in 23 (92%) of 25 CAPD-patients with peritonitis by the Hemobact method and only in 6 (24%) by the standard technique. Sixty-four (100%) of the 64 samples taken during periods without peritonitis were negative by the standard technique. Sixty-two (97%) of the 64 samples were negative in the Hemobact system. In the remaining two samples coagulase negative staphylococci were demonstrated on the third day in only one of the bottles. In conclusion, blood cultivation systems should be preferred to conventional standard methods for adequate microbiological diagnosis in CAPD-patients with peritonitis.
Adult↗
Value of clinical decision on antibiotic treatment of fever episodes following transurethral resection of the prostate.
The value of clinical decision on antibiotic treatment of fever episodes following transurethral resection of the prostate was assessed in 134 patients. Besides bacteriuria, need of blood transfusions and various catheter problems were associated with a significant number of fever episodes. The majority of patients with fever not given antibiotic therapy had negative urine cultures (90%), whereas 41% of the patients with fever treated with antibiotics showed negative urine cultures indicating an overtreatment of these patients. Out of the total number of patients, only 10% with subsequent negative urine cultures received antibiotics, a figure which should be compared to the inevitable rate of overtreatment when general antibiotic prophylaxis is preferred.
Aged↗
Catheter-associated bacteriuria. A controlled trial with the Bardex Urinary Drainage System.
In a randomized trial, the Bardex Urinary Drainage System was tested against a routine system consisting of a silicone-coated 16F Latex Foley catheter and exchangeable 1 500 ml collecting bags. The Bardex system consists of an all-silicone balloon catheter preconnected and sealed to the drainage tube with tape. The tube is united with a 2,000 ml collecting bag via a vented drip chamber. It has an extremely hydrophilic coating (BN-74) resembling the natural glycosaminoglycans lining the urothelium. This coating is intended to minimize urethral irritation and bacterial migration and also to cause slow release of water-soluble antiseptics applied to the surface. In the present study, isobetadine 10% was applied prior to the insertion and reapplied daily after pulling gently on the catheter. Forty female patients aged 31 to 85 years completed the study. In the Bardex group of patients, bacteriuria developed in none by the third day of catheterization and in 5% by the fourth day. In the Foley group, the bacteriuria rate was significantly higher, with 35% on the third day (p less than 0.01) and 45% on the fourth day (p less than 0.02). No difference between the two drainage systems was found concerning incontinence beside the catheter, urethral pain or burning, meatal reddishness or urethral discharge. No conclusion regarding the advantages or disadvantages of the BN-74 coating and the isobetadine application can be drawn from the present study.
Adolescent↗
Treatment of serious urological infections with cefotaxime compared to ampicillin plus netilmicin.
Fifty-nine patients with severe urinary tract infections were treated with either cefotaxime or ampicillin plus netilmicin in a controlled, open randomised study of the clinical and bacteriological effects. The patients responded favourably in both groups. The minimum inhibitory concentrations of cefotaxime against the isolates from blood were low for all bacterial strains except one (Streptococcus faecalis). Time to normalisation of temperature was significantly shorter in the cefotaxime group. The results suggest that cefotaxime is an effective and well-tolerated agent in the treatment of serious infections. However, the difference between the two groups was too small to allow preference of one procedure over the other.
Ampicillin↗
Analysis of vanillylmandelic and homovanillic acids in urine using solid phase sample preparation and high pressure liquid chromatography with electrochemical detection.
A rapid, simple and specific method for quantification of vanillylmandelic acid (VMA) and homovanillic acid (HVA) in urine is described. The method is suitable for routine use and may include other organic acids in human urine.
Chromatography, High Pressure Liquid↗
Rapid identification of Capnocytophaga isolated from septicemic patients.
Four Capnocytophaga strains from blood cultures of immunocompromised patients with malignant disease and the type strains of three Capnocytophaga species were examined and compared to strains representing five other genera that are hard to differentiate from Capnocytophaga. With three rapid identification methods, negative catalase and oxidase reactions and positive ONPG assay, Capnocytophaga was easily separated from Eikenella corrodens, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, and CDC group DF-2. Haemophilus aphrophilus was excluded by leucine, valine and cystine arylamidase and alpha-glucosidase reactions (API ZYM). Further confirmatory reactions constituted gelatin hydrolysis, haemin requirement, and carbohydrate and esculin breakdown. Although rapid identification of Capnocytophaga to the genus level was feasible, differentiation on a species level proved impossible.
Capnocytophaga↗
The cultivation and rapid enzyme identification of DF-2.
The investigation of two clinical isolates and two reference strains of DF-2 showed that supplementary cysteine and incubation in a humid atmosphere were important growth-promoting factors for these fastidious, gram-negative bacteria. Broth-base media with phenol red indicator were proven to be satisfactory for carbohydrate fermentation tests. Two four-hour enzyme assays (API ZYM and Rosco Diagnostic Tablets) were used to compare the enzymatic activity of DF-2 with that of 27 species of other non-enterobacterial organisms. The Rosco assay revealed that only the DF-2 strains had a positive alpha-fucosidase reaction, suggesting that this character may provide the means for rapid characterization and identification of these bacteria and also be of value for taxonomic classification. The incongruent results of the API ZYM assay seem to be due to the different substrates of the two assay systems.
Bacteriological Techniques↗
Prediction of fatality in fulminant hepatic failure.
Thirty-three consecutive patients admitted to the intensive care liver unit of Rigshospitalet with acute hepatic encephalopathy induced by viral hepatitis, drugs, or pregnancy were studied. All were treated with a standard anticoma regime. The 20 patients (61%) who died had a higher bilirubin level and lower total cholic acid conjugation and glycine cholic acid conjugation (p less than 0.05) than the surviving patients. Antipyrin clearance and galactose elimination capacity tended to be lower in the non-survival group than in the survival group (p = 0.09 and 0.11, respectively). Of single variables a bilirubin level of greater than 384 mumol/l gave the best prediction of non-survival (sensitivity, 0.80; specificity, 0.69; PVpos, 0.80; PVneg, 0.69; kappa, 0.49). However, a discriminant score based on combination of variables distinguished completely between non-survivors and survivors when validated by an unbiased method in which each patient is classified on the basis of the other patients' data. It is suggested that the discriminant score is used to select patients with very low probability of survival for liver transplantation or liver assistance procedures of unknown value.
Adult↗
Precursor of 27-nor-5 beta-cholestane-3 alpha, 7 alpha, 12 alpha, 24,25-pentol in man.
Cholesterol was shown to be the precursor of 27-nor-5 beta-cholestane-3 alpha, 7 alpha, 12 alpha, 24,25-pentol which is the major bile alcohol in human urine. 4-[14C]-Labelled cholesterol and beta-sitosterol were administered to patients with primary biliary cirrhosis. Urine was extracted with Amberlite XAD-2 and sterol glucuronides and bile acid conjugates were isolated by ion exchange chromatography on Lipidex-DEAP. Following hydrolysis and further purification on Lipidex-DEAP, the C26 bile alcohol and methyl esters of cholic and chenodeoxycholic acids were isolated by HPLC. The specific radioactivity of the C26-pentol was the same as that of cholic acid after administration of [14C]-cholesterol. In contrast, little if any radioactivity could be detected in the C26-pentol after administration of labelled beta-sitosterol.
Bile Acids and Salts↗
Cholic acid conjugation test and quantitative liver function in acute liver failure.
In 33 patients with acute hepatic encephalopathy due to toxic or viral hepatitis the following analyses were performed: (24-14C)cholic acid conjugation and sulfation, plasma phenazone clearance, galactose elimination capacity, and concentrations of glycocholic acid and glycolithocholic acid sulfate in plasma. The (24-14C)cholic acid conjugation in patients with viral hepatitis was significantly lower in fatal cases than in patients who survived (p less than 0.002). In these patients the galactose elimination capacity and the plasma phenazone clearance were insignificantly lower. Tauro-(24-14C)cholic acid was the predominant metabolite of (24-14C)cholic acid in six patients, but in four patients with toxic hepatitis this metabolite was only found in trace amounts. Sulfation after 3 h of (24-14C)cholic acid accounted for 0-8.2% of the administered dose. The sulfate of glycolithocholic acid was found in the plasma of all patients. No survival limit with regard to the capacity for the (24-14C)cholic acid conjugation could be defined.
Acute Disease↗
Bile acids in plasma of patients without kidneys.
Bile acids were measured in plasma of three non-fasting bilaterally nephrectomized patients in chronic haemodialysis. After separation of the bile acid mixture according to mode of conjugation and cleavage of amide and sulphate ester bonds, the bile acids were analysed as their methylester trimethylsilyl ethers on gas-liquid chromatography-mass spectrometry (GC-MS). The total bile acid concentration was 4.10-13.70 mumol X l(-1) (N: less than 14 mumol X l(-1)) mostly glycine conjugates. Unconjugated bile acids were found in significant amounts in one patient and in trace amounts in another patient. Chenodeoxycholic acid was the predominant individual bile acid constituting 1.89-6.79 mumol X l(-1) (N: less than 10 mumol X l(-1)). The oxidoreduction product of this bile acid: ursodeoxycholic acid, was found in all patients, whereas the 7 alpha-dehydroxylation product: lithocholic acid, was absent. 1 beta-hydroxy-deoxycholic acid was a major constituent in two of the cases. Hyocholic acid, the 6 alpha-hydroxylation product of chenodeoxycholic acid was detected in two cases. Tetrahydroxy bile acids and sulphated bile acids were not found in significant amounts.
Adult↗
Microbiological and immunological studies in a case of human melioidosis diagnosed in Denmark.
The first case of melioidosis reported in Denmark was in a 64-year-old man 2 weeks after his return from a 3-week visit to Kenya. The clinical course was characterized by septicaemia and Pseudomonas pseudomallei was isolated from repeated blood cultures, urine and sputum. Transient impairment of cellular immunity was observed. During the convalescence a cell-mediated immune response against the pathogen was detected by the lymphocyte blast transformation test. Two precipitins against P. pseudomallei were detected by crossed immunoelectrophoresis; the most pronounced was directed against the common antigen of P. aeruginosa. The patient was treated with a combination of oxytetracycline, sulfamethoxazole and trimethoprim for one month, followed by sulfamethoxazole and trimethoprim for another month. The clinical response to the treatment was good. The patient had previously had recurrent pulmonary tuberculosis. The relationship of melioidosis to tuberculosis is briefly discussed.
Animals↗
[Abuse of appetite depressants].
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Adult↗
In vitro activity of azlocillin, carbenicillin, mezlocillin and piperacillin against Pseudomonas aeruginosa.
50% inhibitory concentration (IC50) of azlocillin, carbenicillin, mezlocillin and piperacillin against 157 strains of P. aeruginosa were determined by means of the agar plate-dilution method. The 3 new semisynthetic penicillins were significantly more active against P. aeruginosa than carbenicillin; azlocillin and piperacillin were 8-fold, and mezlocillin was 2-4-fold more active than carbenicillin. More than 95% of the P. aeruginosa strains were inhibited by 16 micrograms/ml of azlocillin or piperacillin whereas 64 micrograms/ml of mezlocillin and 256 micrograms/ml of carbenicillin, respectively, were necessary to inhibit 95% of the strains.
Azlocillin↗