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Biomedical subjects

A Heimdahl

Publications and source records attributed to A Heimdahl.

At least 73 records · Page 4Linked to original sources
PubMed1988

Microbial colonization of tumors in relation to the upper gastrointestinal tract in patients with gastric carcinoma.

The microbial colonization of the oropharynx, the esophagus, the stomach, and the duodenum was studied in relation to the microbial flora found on tumor and gastric mucosal biopsies in 23 patients with gastric carcinoma. The tumor was colonized in all patients, and the stomach, the esophagus, the duodenum, and the gastric mucosa were colonized in 96%, 87%, 83%, and 78% of the patients, respectively. The most common microorganisms isolated were streptococci, bifidobacteria, lactobacilli, and Bacteroides species, belonging to the normal oropharyngeal flora. Microbial colonization with gram-negative rods, Clostridium species or yeasts, was present in at least one site in 91% of the patients. Clostridium species were isolated from 57% of the patients. The total numbers of microorganisms recovered from the tumor biopsies did not vary with the intraluminal gastric pH. A relation between the gastric pH and the total number of microorganisms in the gastric juice existed. Significant higher numbers of different strains of microorganisms (p less than 0.005) colonized the tumor compared to the gastric mucosa. Anaerobic microorganisms colonized the tumor significantly more often than the mucosa (p less than 0.001). Antibiotic agents used as prophylaxis in gastric cancer surgery should cover both aerobic and anaerobic microorganisms, including B. fragilis.

Aged↗
PubMed1988

Lymphocyte and IgG responses to different herpes simplex virus antigens in patients with frequent HSV-1 reactivations.

Seventeen patients with a history of frequent clinical herpes simplex (HSV) reactivations and 13 HSV seropositive controls were monitored for 6 months. The patients had 4-8 clinical reactivations during the study. No clinical HSV reactivations were observed in the controls. IgG subclasses directed against HSV-1 nucleocapsid, membrane and glycoprotein C (gC) antigens were determined after the study period. Anti-HSV IgG4 directed against gC was found more often in the patients (65%) than in the controls (8%, P less than 0.025). The same trend was seen for IgG4 against HSV nucleocapsid antigen (88 and 46%, n.s.) and HSV membrane antigen (82 and 38%, n.s.). In both patients and controls IgG3 was found more often against nucleocapsid antigen compared to membrane or gC antigens (P less than 0.001). Lymphocytes were stimulated with the different antigens and the anti-HSV IgG subclass responses and cellular proliferation were determined. Lymphocyte produced IgG4 against HSV nucleocapsid antigen was found more often in patients than in controls (47 and 8%, P = 0.05) and membrane antigen (41 and 0%; P less than 0.025). No differences were found in the magnitude of lymphocyte proliferation responses between patients and controls. Lymphocyte proliferation responses were stronger to nucleocapsid antigen than to membrane or gC antigens (P less than 0.01).

Adult↗
PubMed1988

Antimicrobial agents in the treatment of periodontal diseases: special aspects on tetracycline and doxycycline.

Increasing evidence for the involvement of specific microorganisms in the etiology of human periodontal diseases has appeared during the last few years. The microorganisms most likely to cause periodontal disease are Actinobacillus actinomycetemcomitans, Bacteroides gingivalis, Bacteroides intermedius and Capnocytophaga species. Many of the strains are resistant to tetracycline and doxycycline. Recently penicillin-resistant B. gingivalis and B. intermedius have also been described. A. actinomycetemcomitans strains and capnocytophaga strains are sensitive to tetracycline and doxycycline. This has raised the question if periodontal diseases are possible to treat with antimicrobial agents alone or in combination with scaling of the teeth and surgery. Although numerous studies with different antimicrobial agents have been published it is still controversial if antimicrobials agents have a role in the treatment of human periodontal diseases. Comparative randomized long term studies are still needed to answer this question.

Anti-Bacterial Agents↗
PubMed1988

Oral condition in children treated with bone marrow transplantation.

Oral health was studied in 49 children below 12 years of age treated with bone marrow transplantation (BMT). Dental treatment prior to BMT was required in 41% of the children. Ulceration of the mucous membranes in the mouth was observed in 37% of the patients during treatment. Those given methotrexate as prophylaxis against graft-versus-host disease (GVHD) exhibited oral ulcerations more frequently (p less than 0.05) than those given cyclosporin. One year after BMT all patients with a clinical chronic GVHD exhibited changes in the oral mucosa. During the first year after BMT 31% of the children developed carious lesions. Children treated with 10 Gy total body irradiation (TBI) had a significantly (p less than 0.05) reduced salivary secretion rate. Dental development was severely affected in children treated with TBI. These disturbances consisted of arrested root development, enamel hypoplasias and microdontia.

Bone Marrow Transplantation↗
PubMed1988

Beta-lactamase producing anaerobic bacteria in the oropharynx and their clinical relevance.

The mechanisms of resistance to beta-lactam antibiotics in anaerobic bacteria are production of beta-lactamases, alteration of penicillin-binding proteins and blocked penetration of beta-lactam agents through the outer membranes. The most important factor in beta-lactam resistance is production of beta-lactamase. Beta-lactamases have been found in oropharyngeal strains of bacteroides and fusobacteria isolated from orofacial infections, peritonsillitis and recurrent tonsillitis. Clinical failures with penicillin therapy of these infections are reported in an increasing frequency and other antimicrobial agents such as clindamycin and metronidazole should be considered in the treatment of these failures.

Bacteria, Anaerobic↗
PubMed1988

Impact of different antimicrobial agents on the colonisation resistance in the intestinal tract with special reference to doxycycline.

The administration of antimicrobial agents has a number of effects on the intestinal microflora. One is the reduction of colonisation resistance, i.e., the resistance displayed by the host to implantation of new microorganisms in the intestinal microflora. In the present investigation, the impact of three antimicrobial agents--clindamycin, doxycycline and erythromycin--on the colonisation resistance in the intestinal human microflora was examined. Two of the agents--clindamycin and erythromycin--disturbed the colonisation resistance and caused ecological changes, while the third agent--doxycycline--better preserved the colonisation resistance. Ecological effects are difficult to foresee and clinical studies of antimicrobial agents should include investigations of the impact on the normal human intestinal microflora.

Adult↗
PubMed1988

A micromethod for determination of antimicrobial agents in bone.

A microtechnique, requiring very small amounts of tissue material, was developed for assay of antimicrobial agents in bone. Without previous homogenization or extraction, small bone pieces (mean weight 0.014 g) from human subjects and pigs were placed into wells in agar plates preinoculated with the test strain. Round and distinct zones of inhibition were formed around the pieces. Standards for ampicillin and flucloxacillin were prepared from freeze-dried bone pieces from human subjects and pigs with known amounts of antibiotics as well as in human plasma and phosphate-buffered saline (PBS). Curves obtained from these standards were linear. Bone pieces from human and pig maxilla gave superimposable curves, but differed from curves obtained in plasma or PBS. The method was used in a pharmacokinetic study of bacampicillin in human maxillary bone and plasma. Bacampicillin tablets (2 X 400 mg) were given to patients before oral surgery. Standardized bone pieces and plasma samples were obtained at different times during surgery. The peak ampicillin concentrations estimated from the population curves were 8.0 mg/l in plasma and 1.1 mg/l in maxillary bone. The elimination half-life of ampicillin was similar in plasma and maxillary bone.

Ampicillin↗
PubMed1987

Selective suppression of the anaerobic oropharyngeal microflora with local metronidazole.

Anaerobic microorganisms of the normal oropharyngeal flora have been shown to be the main pathogens in orofacial infections of odontogenic origin. Reduction of the density of anaerobes in the oral cavity as a prophylactic measure before oral surgery may be a rational way to reduce the frequency of post-operative infections. This report describes a local antibiotic regimen that can reduce anaerobic pathogens in the oral cavity. Over a period of 7 days, 10 healthy individuals applied locally 1.5-2 g of an antibiotic preparation consisting of 0.5% metronidazole in 99.5% Orabase paste three times daily. The paste had antibacterial activity against obligate anaerobic micro-organisms such as bacteroides, fusobacteria and leptotrichia, known pathogens in orofacial infections. Fusobacteria and leptotrichia were eliminated in all subjects. Bacteroides species were eliminated in five subjects and significantly decreased in three subjects. The aerobic microflora was not affected. No new colonisation of the oropharynx was observed during the treatment period. The pre-treatment numbers of different micro-organisms were re-established within 2-9 days after the withdrawal of metronidazole treatment.

Adult↗
PubMed1987

Impact of cefaclor on the normal human oropharyngeal and intestinal microflora.

Cefaclor was given orally in doses of 250 mg every 8 h for 7 days to 10 volunteers. Saliva and faecal specimens were taken up to 16 days for cultivation of aerobic and anaerobic microorganisms and for assay of cefaclor. Cefaclor was not detected in saliva or faeces. In the oropharynx only minor changes in the anaerobic part of the microflora were observed. The microflora was normalized within 1 week after the administration of cefaclor had stopped. The aerobic intestinal microflora was unchanged during and after cefaclor administration while a minor impact on the anaerobic intestinal microflora was observed. The anaerobic intestinal flora returned to its normal state within 1 week. No new colonization with cefaclor resistant microorganisms were observed and no side effects were registered during the investigation period.

Adult↗
PubMed1986

Changes in the protein composition of whole saliva during radiotherapy in patients with oral or pharyngeal cancer.

We analyzed the radiation-induced changes in the flow rate and protein composition of stimulated whole saliva in eleven patients treated for malignant conditions of the head and neck. In all patients the radiation field covered all major salivary glands and a large area of the oral mucosa. Paraffin-stimulated whole saliva samples were collected once 2 to 21 days before therapy and then after 20, 40, and 60 gray (Gy) cumulative dose of irradiation. Five patients also provided samples 6 months after the therapy. Hyposalivation or xerostomia occurred in all patients, although the pretreatment secretion rates were already relatively low. Salivary amylase activities decreased with increasing dose of radiation, especially when expressed as the amount of enzyme secreted per minute. Unusually high salivary concentrations of albumin, lactoferrin, lysozyme, salivary peroxidase, myeloperoxidase, and total protein were observed during the therapy, but most values slowly returned to pretreatment levels after cessation of radiation. It is concluded that the observed qualitative changes in whole saliva components are net effects caused by the cancer itself, radiation therapy given, systemic diseases, or medications, as well as mucosal inflammations.

Adult↗
PubMed1986

Experimental mandibular Staphylococcus aureus osteomyelitis; antibody response and treatment with dicloxacillin.

Staphylococcus aureus mandibular osteomyelitis was produced in 20 rabbits by injection of a sclerosing agent and 1 X 10(9) colony-forming units of Staphylococcus aureus V8 into the medullary cavity of the mandible. After 2 weeks all rabbits developed infections. 10 of the rabbits were then treated with dicloxacillin (22.5 mg/kg body weight) every 12 h for 7 days and 10 were left untreated. The animals were sacrificed after 8 weeks and histopathological examination was performed. An enzyme-linked immunosorbent assay (ELISA) was used to measure IgG response against staphylococcal teichoic acid and alpha-toxin during the observation period. In the treated group, there was a decrease in clinical symptoms after the treatment period, while in the untreated group, progression of the infection was a common finding. At the end of the treatment period, Staphylococcus aureus V8 could not be recovered from aspirates obtained from animals in the treatment group, while in the non-treatment group, Staphylococcus aureus V8 could be recovered from abscesses in 6 rabbits. Both in the treated group and in the untreated group, the rabbits showed increasing IgG titers against teichoic acid and alpha-toxin during the first 2-3 weeks. No significant differences in antibody response patterns were noted between the treated and untreated groups and no clear correlation between the immunological response and the severity of the disease was observed.

Animals↗
PubMed1986

Impact of orally administered antimicrobial agents on human oropharyngeal and colonic microflora.

Phenoxymethylpenicillin, bacampicillin, clindamycin, erythromycin and doxycycline were given orally to 46 subjects for seven days. The numbers of aerobic and anaerobic bacteria in the oropharyngeal and colonic microflora were determined as were the concentrations of antimicrobial agents in saliva and faeces. Clindamycin, erythromycin and doxycycline were detected both in saliva and faeces. Phenoxymethylpenicillin, bacampicillin and doxycycline caused only minor changes in the microflora, while pronounced suppression of anaerobic bacteria was noticed when clindamycin was administered. Erythromycin decreased the aerobic bacteria in the oropharynx and both aerobic and anaerobic bacteria in the colon. New colonizing clostridia, enterobacteria and fungi were found both in the oropharynx and in the colon when erythromycin and clindamycin were administered.

Administration, Oral↗
PubMed1986

Alterations in the human oropharyngeal microflora related to therapy with aztreonam, moxalactam and ampicillin plus sulbactam.

33 patients undergoing colorectal surgery were treated prophylactically with aztreonam (19 patients), moxalactam (10 patients) and ampicillin plus sulbactam (4 patients). The effect on the normal oropharyngeal microflora and new colonization of oropharynx were studied during and after the treatment. Aztreonam had minor effect on the normal flora but induced colonization with staphylococci. Moxalactam suppressed gram-negative aerobic and anaerobic bacteria and promoted colonization with Candida albicans. Ampicillin plus sulbactam had marked effect on the normal flora and suppressed aerobic as well as anaerobic bacteria. New colonization with enteric gram-negative rods or fungi was observed in all patients.

Adult↗
PubMed1986

A randomized trial comparing use of cyclosporin and methotrexate for graft-versus-host disease prophylaxis in bone marrow transplant recipients with haematological malignancies.

Patients with haematological malignancies with HLA-identical marrow donors were randomized to treatment with cyclosporin (CSA) or methotrexate (MTX). Two of the 29 patients randomized to MTX died before engraftment compared with none of the 30 treated with CSA. Engraftment by leucocytes (P less than 0.0001), granulocytes (P less than 0.02), and reticulocytes (P less than 0.01) was faster among the CSA patients. There were no significant differences between the two groups regarding transfusions, hospitalization and incidence of early septicaemia. Granulocyte transfusions were required in seven of 29 MTX and two of 30 CSA patients (not significant: NS). Overall (grade I-IV) acute graft-versus-host disease (GVHD) was more common (P = 0.001) in the CSA patients. Grade II-IV acute GVHD was seen in 40% of the CSA patients compared with 22% in the MTX patients (NS). In the adult patients grade II-IV GVHD was slightly more common (P less than 0.05) in those treated with CSA compared with MTX. Chronic GVHD appeared in 30 and 39% in the two groups respectively. Actuarial 3-year survival was 58% for the CSA patients and 69% for the MTX patients. There were no significant differences regarding the incidence of interstitial pneumonitis or relapses between the two groups. The side-effects of CSA treatment includes nephrotoxicity (83%), hepatotoxicity (20%), hirsutism (43%), hypertension (23%), tremor (27%) and gingival hyperplasia (27%). Serum creatinine values were increased at 3 and 6 months in the CSA group but were within the normal range after 6 months. A blind study on oral side-effects revealed that CSA patients more often had a normal mucosa (P = 0.025) and less frequently had mucositis (P = 0.01) compared with the MTX group.

Acute Disease↗
PubMed1986

Antimicrobial induced alterations of the human oropharyngeal and intestinal microflora.

Although the role of the normal oropharyngeal and intestinal microflora is not fully understood, there are evidences that alterations in the flora may have serious consequences. The most common and significant cause of disturbances in the normal microflora is the administration of antimicrobial agents. The microflora can be influenced by antimicrobial agents because of incomplete absorption of any orally administered antimicrobial agent, secretion of an antimicrobial agent by the salivary glands or in the bile, or secretion from the intestinal mucosa. In most cases the influence is not beneficial to the patient because suppression of the indigenous microorganisms often permits potential pathogens to overgrow and cause septic conditions, stomatitis, diarrhoea, or colitis. Antimicrobial agents that influence the normal microflora also promote the emergence of antimicrobial-resistant strains. During the recent years, the impact of different antimicrobial agents on the human microflora has been investigated by our research group. Thus the effects on the oropharyngeal and intestinal microflora by peroral administration of penicillin, bacampicillin, erythromycin, clindamycin, doxycycline, nitroimidazole, norfloxacin and ciprofloxacin have been studied. The impact on the microflora by parenteral administration of ampicillin + sulbactam, azlocillin, aztreonam, piperacillin, cefoperazone, cefoxitin, ceftriaxone, moxalactam, imipenem, nitroimidazole and clindamycin has also been investigated. Pronounced changes were observed in the microflora in patients receiving clindamycin, erythromycin, cefoperazone, ceftriaxone and moxalactam, whereas moderate changes were seen in those patients receiving doxycycline, cefoxitin, aztreonam, ampicillin + sulbactam, azlocillin and piperacillin. Penicillin, bacampicillin, imipenem, nitroimidazole, ciprofloxacin and norfloxacin produced only minor changes.(ABSTRACT TRUNCATED AT 250 WORDS)

Anti-Bacterial Agents↗