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Biomedical subjects

A Gerber

Publications and source records attributed to A Gerber.

At least 19 recordsLinked to original sources
PubMed1992

Treatment of streptococcal endocarditis with a single daily dose of ceftriaxone sodium for 4 weeks. Efficacy and outpatient treatment feasibility.

UNLABELLED: OBJECTIVE--To evaluate the efficacy and safety of ceftriaxone sodium in the treatment of streptococcal endocarditis. DESIGN--An open, multicenter, noncomparative study with a follow-up of patients for 4 months to 5 years. SETTING--Internal medicine wards and outpatient clinics of hospitals of various sizes in three European countries. PATIENTS--Fifty-nine patients with defined criteria for streptococcal endocarditis. INTERVENTION--Ceftriaxone sodium administered at a once-daily dose of 2 g for 4 weeks. MAIN OUTCOME MEASURES--Clinical outcome and microbiological cure rate. RESULTS--Among the 59 patients, 55 completed the treatment and were followed up for 4 months to 5 years. No patients showed evidence of relapse. Treatment was completely uneventful in 42 patients (71%). A cardiac valve was replaced in four patients (7%) receiving antimicrobial therapy and in six patients (10%) who had completed antimicrobial therapy. One of the 10 valves taken for culture at surgery was positive, but only for microorganisms that were different from the microorganism isolated before the treatment. The treatment had to be interrupted in four patients because of drug allergy. Other side effects were mild except for two cases of reversible neutropenia. The treatment was easy to administer: 27 patients (46%) had no permanent intravenous catheter at any time, seven patients (12%) had such a catheter for less than 4 days. Twenty-three patients (39%) were discharged from the hospital less than 2 weeks after admission. CONCLUSIONS: --Ceftriaxone sodium administered at a once-daily dose of 2 g appears to be an effective and safe treatment of streptococcal endocarditis. In hospitals, this agent may be more convenient to administer than penicillin G with or without aminoglycosides. Some patients may even be treated as outpatients.

Adult↗
PubMed1991

[The treatment of heart insufficiency in coronary heart disease].

In acute as well as in chronic ischemic heart disease, congestive heart failure indicates a poor prognosis. Treatment after acute myocardial infarction should differentiate between specific subsets. In cardiogenic shock due to extensive ischemic damage, acute revascularization by PTCA or CABG improves the otherwise poor outcome substantially. In congestive heart failure, pre- and afterload reduction by nitrates should be combined with dopamine if systolic blood pressure is below 100 mmHG or dobutamine if an inotropic substance is necessary despite systolic blood pressure greater than 100 mmHg. Amrinone is a potent alternative which combines positive inotropic and vasodilating properties. In chronic ischemic heart disease, congestive heart failure is a clearly defined indication for complete revascularization, if possible. As to drug treatment, progression of the disease characterized by a cardiomyopathy of overload as well as neurohormonal and peripheral maladaptation should be stopped in parallel with symptom relief. Therefore, ACE-Inhibitors are combined very early with diuretic treatment, and digitalis should be added in refractory patients.

Amrinone↗
PubMed1990

Severe neonatal asphyxia due to X-linked centronuclear myopathy.

Severe neonatal centronuclear myopathy is inherited as an X-linked condition characterized by primary asphyxia, extreme muscular hypotonia and absent spontaneous movements. We report seven cases from three families to point out the importance of diagnosis with regard to prognosis, outcome and genetic counselling. In hypotonic diseases, analysis of cerebrospinal fluid, electromyography, nerve conduction velocity creatine kinase and a skin biopsy for fibroblast cultures for metabolic investigations are usually carried out. Needle muscle biopsy is an additional valuable investigation to establish diagnosis. In all our patients we found an increased number of centrally located nuclei with perinuclear halos confirming the diagnosis of centronuclear myopathy. The diagnosis of this disorder will become of greater importance as soon as carrier detection and prenatal diagnosis by DNA-technology are routinely available.

Asphyxia Neonatorum↗
PubMed1990

X linked neonatal centronuclear/myotubular myopathy: evidence for linkage to Xq28 DNA marker loci.

We have studied the inheritance of several polymorphic Xq27/28 DNA marker loci in two three generation families with the X linked neonatal lethal form of centronuclear/myotubular myopathy (XL MTM). We found complete linkage of XLMTM to all four informative Xq28 markers analysed, with GCP/RCP (Z = 3.876, theta = 0.00), with DXS15 (Z = 3.737, theta = 0.00), with DXS52 (Z = 2.709, theta = 0.00), and with F8C (Z = 1.020, theta = 0.00). In the absence of any observable recombination, we are unable to sublocalise the XLMTM locus further within the Xq28 region. This evidence for an Xq28 localisation may allow us to carry out useful genetic counselling within such families.

Cell Nucleus↗
PubMed1990

Passive smoking and 20-year cardiovascular disease mortality among nonsmoking wives, Evans County, Georgia.

The association of passive smoking and cardiovascular disease (CVD) mortality was assessed in a cohort of 513 rural, married Black and White women who were disease-free and self-described as never-smokers at baseline in 1960. Over a 20-year period, 76 of 147 total deaths were attributed to CVD. Relative risk estimates adjusted for age, cholesterol, blood pressure, and body mass from proportional hazards models were 1.59 for CVD (95% CI = 0.99, 2.57) and 1.39 (CI = 0.99, 1.94) for all cause mortality among women with husbands who smoked cigarettes.

Adolescent↗
PubMed1979

[In vitro study on the problem of optimal gentamicin therapy in leukopenic patients: short injections or parenteral infusions?].

Killing curves of Pseudomonas aeruginosa were performed in an in vitro system simulating in-vivo gentamicin kinetics, i.e. decay of the antibiotic concentration with a 2.1 h halflife time. Minimal inhibitory concentrations (MIC) of gentamicin killed 99.999% of the initial Pseudomonas inoculum whereas 99.99% were killed at a continuously falling gentamicin concentration (starting from the MIC level) in the same period of time. Regrowth of persistent germs occurred only after 6 hours in cultures exposed to falling gentamicin concentrations, and after 8 hours in cultures kept at the MIC. Thus, a postulated superiority of gentamicin infusions over intermittent gentamicin therapy could not be demonstrated in vitro. Intervals between bolus injections of gentamicin should probably not be longer than 6 hours.

Colony-Forming Units Assay↗
PubMed1979

[Metabolism of antipsoriatic anthrone derivatives].

The metabolisation of the antipsoriatically active molecules 1,8,9-triacetoxy-anthracene und 1,8-diacetoxy-9-anthrone by serum is described. Under these conditions 1,8-dihydroxy-9-anthrone, 1-hydroxy-8-acetoxy-9-anthrone, 1,8,1',8'-tetrahydroxy-bisanthrone, 1,8-dihyroxy-anthraquinone, 1,8-diacetoxy-anthraquinone and 1-hydroxy-8-acetoxy-anthraquinone arise from both educts. Quantitative determinations of these metabolites indicate that hydrolytic reactions occur prior to oxidation. Contrary to 1,8-dihydroxy-9-anthrone, 1,8,9-triacetoxyanthracene and 1,8-diacetoxy-9-anthrone are effective against psoriatic lesions without accompanying inflammations of the skin. 1,8,9-Trimethoxy-anthracene, however, is ineffective, also indicating that at least 1,8,9-triacetoxy-anthracene is a prodrug.--In agreement with Krebs' hypothesis 10,10-dialkylated 1,8-dihydroxy-9-anthrones described in this paper are ineffective against psoriasis.

Anthracenes↗
PubMed1978

[Infusion kinetics of drugs injected into the drip chamber of an infusion set].

The infusion kinetics of drugs injected into the "drip-chamber" of an i.v. infusion set has never been studied, although this route of drug administration is used more and more frequently in hospitalized patients. The drug is eliminated from this "drip-chamber" and hence infused into the body by 1.-order kinetics. A half-life of administration can be calculated and experimentally verified. This t 1/2 is equal to the ratio of the volume of infusion fluid in the "drip-chamber" (which can be estimated) and the infusion velocity of the i.v. drip (which is chosen) with the ln 2 as the proportionality constant. Hence the velocity of administration of the drug is not constant. Just after the injection more of the drug reaches the body per unit time than later on. This type of drug administration should therefore not be used if high plasma concentrations at the beginning are to be avoided or a constant infusion is desired.

Infusions, Parenteral↗