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Biomedical subjects

A Bucher

Publications and source records attributed to A Bucher.

12 recordsLinked to original sources
PubMed1992

Spectrum of disease in bacteraemic patients during a Streptococcus pyogenes serotype M-1 epidemic in Norway in 1988.

All 87 known cases of bacteraemia due to Streptococcus pyogenes (beta-haemolytic group A streptococci) occurring during the peak of a nationwide outbreak in Norway (population 4.2 million) between January and June 1988 were reviewed. Clinical features varied widely and appeared largely to be dependent on the patients' age. The case fatality rate ranged from 11% in the age group under 30 years to 44% in patients over 60 years. Clinical complications such as shock, severe renal or respiratory failure or serious local infection occurred particularly in 30-to 59-year old individuals. Shock was manifest in 32% of the patients and carried a 68% case fatality rate. Chronic heart disease in the elderly and pneumonia seemed to be associated with a fatal outcome. In the 25 patients (29%) who died the disease showed a fulminant course, 80% dying within 48 hours after admission. However, 56% of the patients had experienced symptoms for more than two days before admission, suggesting that early diagnosis and treatment might possibly have prevented the development of a serious disease. This study revealed a wide spectrum of clinical manifestations in bacteraemia cases in a unique epidemiological situation caused largely by a single serotype of Streptococcus pyogenes; 89% of the 27 preserved bacteraemia strains carried the M-1 antigen. The observations call attention to the ability of these organisms to cause fulminant clinical illness, indicating a probable increase in both invasiveness and toxicity of group A streptococci responsible for the epidemic.

Adolescent↗
PubMed1992

Comparison of light treatment with citalopram in winter depression: a longitudinal single case study.

A woman with seasonal affective disorder (SAD) remitted within a week in each of six separate trials of light therapy. She remitted within 2 weeks of initiating citalopram treatment. Light treatment in the morning advanced and improved sleep, whereas citalopram delayed sleep and induced intermittent awakenings. These opposite patterns suggest that sleep deprivation or sleep shifts were not crucial for eliciting therapeutic response. Light and citalopram both selectively reduced intake of sweet carbohydrate parallel with improvement, implicating CNS serotonergic mechanisms in the interaction of mood and food in winter.

Adult↗
PubMed1991

[Quantification of T-lymphocyte subpopulations. Immunological marker in human immunodeficiency virus infections].

The absolute number of CD4+ and CD8+ T cells was counted directly in the blood of 75 healthy controls and 223 individuals infected with human immunodeficiency virus (HIV). The HIV-seropositive individuals were also classified clinically according to the system recommended by the Centers for Disease Control. We observed a pattern of changes in the T cell subset counts of the patient group. This pattern could be defined by five T cell stages ranging from normal T cell subset values to values representing severe T cell immunodeficiency. A close correlation was observed between the immunological and clinical classification of the patients. Quantification of T cell subsets may provide useful information in the follow-up of individuals infected with HIV, particularly in assessing the indications for antiviral therapy, and its effects.

HIV Infections↗
PubMed1991

Adjuvant topical chemotherapy versus immunotherapy in primary superficial transitional cell carcinoma of the bladder.

In a prospective randomised controlled study, the efficacy of ethoglucid was compared with that of keyhole-limpet haemocyanin (KLH) in preventing recurrent tumours following transurethral resection of primary superficial transitional cell carcinoma of the bladder. Patients treated with ethoglucid (n = 39) received 0.565 g (1% solution) ethoglucid weekly for 6 weeks and then monthly for 1 year. Patients treated with KLH (n = 38) were immunised subcutaneously with 1 mg KLH; bladder instillations of 30 mg were then given weekly for 6 weeks and thereafter monthly for 1 year. The recurrence rates, disease-free intervals and tumour progression rates were evaluated. The end-point of the study was either progression in stage or grade or more than 1 recurrence during the observation period. The minimum length of follow-up was 1 year. The recurrence rates, mean disease-free intervals and progression rates in the 2 groups showed no statistically significant differences.

Administration, Intravesical↗
PubMed1990

Septicemia and endocarditis caused by group G streptococci in a Norwegian hospital.

The clinical and bacteriological features of septicemia caused by group G streptococci were analyzed in nine patients seen during a period of 28 months. Four of these patients had acute endocarditis with a high rate of serious neurological complications. The clinical response to antibiotic treatment was slow in the endocarditis patients despite sensitivity of the organism in vitro. Group G streptococcal septicemia can be a very serious condition associated with endocarditis of a destructive nature. Comparison with previous reports suggests that group G streptococcal infections are of increasing importance. The virulence of group G streptococci may be changing, resulting in more serious infections and complications. This series stresses the importance of prompt recognition of this infection and the need for aggressive management of these patients.

Acute Disease↗
PubMed1990

Recurrent superficial transitional cell carcinoma of the bladder: adjuvant topical chemotherapy versus immunotherapy. A prospective randomized trial.

A multicenter, prospective, randomized controlled study was begun in 1985 on the effect of ethoglucid and keyhole-limpet hemocyanin in the prevention of recurrent superficial transitional cell carcinoma of the bladder (stages pTa to pT1, grades 1 to 3 according to the recommendation of the International Union Against Cancer and the World Health Organization). The study was performed on a selected group of patients at high risk for further recurrences. All of these patients were pre-treated with different chemotherapeutic agents (doxorubicin or mitomycin C) and still had recurrent superficial transitional cell carcinoma. All tumors were removed by transurethral resection and all patients were presumed to be free of tumor at initiation of the prophylactic instillations. Patients in the ethoglucid group received 0.565 gm. (solution of 1%) ethoglucid weekly for 6 weeks and then monthly for 1 year. Patients in the keyhole-limpet hemocyanin group were immunized with 1 mg. keyhole-limpet hemocyanin intracutaneously, and then weekly bladder instillations of 30 mg. were given for 6 weeks and then monthly for 1 year. The percentage of recurrences, recurrence rate, interval free of disease, tumor progression and effect on downstaging were evaluated for both therapeutic arms. The percentage of recurrences (60.9% in the ethoglucid group versus 55.3% in the keyhole-limpet hemocyanin group) and the comparison of interval to recurrence for all patients showed no statistical significant difference (p = 0.808, Mantel-Cox test). A comparison of the interval to recurrence in patients with recurrent tumors only showed a mean interval free of disease of 8.8 months for patients given ethoglucid versus 5.5 months for those given keyhole-limpet hemocyanin (p = 0.006, Wilcoxon test). Recurrence rate (4.8 versus 6.5, respectively) and tumor progression rate (21.7 versus 21.1%, respectively) showed no statistically significant difference (p greater than 0.1).

Administration, Intravesical↗
PubMed1990

Chronic neurobrucellosis due to Brucella melitensis.

A 20-year-old male Turkish immigrant to Norway suffering from severe chronic neurobrucellosis with spastic paraplegia and deafness is presented. The diagnosis was established by isolation of Brucella melitensis from cerebrospinal fluid (CSF) culture. Brucella antibody agglutination titers were high in serum and CSF. In spite of intensive, prolonged treatment with a combination of trimethoprim-sulfamethoxazole (TPM-SMZ), rifampicin and doxycycline, the course of the illness was characterized by relapses and severe neurological defects.

Adult↗
PubMed1990

Methodologic and compliance issues in postcoronary bypass surgery subjects.

Persons who engage in preventive health behaviors may reduce the progression of coronary artery disease. The immediate objective of this pilot study was to assess adherence to behavioral lifestyle changes in patients after coronary artery bypass graft surgery by analyzing self-reported responses using objective measures. Data on adherence to diet, exercise, and smoking were collected from questionnaires completed by each subject. Carbon monoxide index, serum cholesterol, pre- and postambulatory pulse rates, and pre- and post-stair-climbing pulse rates were measured. All tests were conducted before discharge and at a one-month follow-up visit. Analysis of objective data showed a statistically significant reduction in total serum cholesterol, decreased smoking behavior, and increased ambulation from before discharge to one-month follow-up. Analyses showed that self reports of adherence to diet, activity, and smoking cessation were consistent with objective measures in at least 50% of subjects. Serial objective measures provide valuable indicators of patient adherence and assist staff in developing individually tailored patient education.

Aged↗
PubMed1979

tcPO2 in pediatric cardiology: application during balloon septostomy, tolazoline administration, and in children with right-to-left shunt.

In pediatric cardiology tcPO2 is useful in monitoring cyanotic children given high-risk therapy such as balloon septostomy or drugs with controversial effects such as tolazoline in persistent fetal circulation. tcPO2 during administration of 100% oxygen enables a rapid, noninvasive differentiation between cyanosis due to intracardiac right-to-left shunt and that due to low cardiac output or pulmonary ventilation or diffusion difficulty. The size of the right-to-left shunt can be roughly estimated from the highest value of tcPO2, this estimation being influenced by anemia, hypothermia, and acidosis, among other factors. A trend of the tcPO2 rise is evident 90 seconds after the beginning of oxygen breathing. If tcPO2 does not rise at least 40 mm Hg over the initial value, a significant right-to-left shunt must be suspected. Interpretation of tcPO2 rise is difficult in dynamic right-to-left shunt, changing with oxygen breathing.

Blood Gas Analysis↗