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Biomedical subjects

B Hofmann

Publications and source records attributed to B Hofmann.

At least 37 records · Page 2Linked to original sources
PubMed1998

[Medical equipment--old, of poor quality and hazardous?].

In the public debate on Norwegian health care it is claimed that hospitals use old and hazardous medical equipment. A survey carried out on 2,031 pieces of equipment at Lillehammer hospital showed an average age of 7.35 years and a mean life span of 14.91 years. The survey showed that the failure rate was highest for newer equipment. It also showed that the operator error rate was higher for newer devices, older equipment being less complex and therefore easier to use. The results did not support the claim that hospitals use old and hazardous medical equipment.

Equipment Failure↗
PubMed1998

Structural investigation of the cofactor-free chloroperoxidases.

The structures of cofactor-free haloperoxidases from Streptomyces aureofaciens, Streptomyces lividans, and Pseudomonas fluorescens have been determined at resolutions between 1.9 A and 1.5 A. The structures of two enzymes complexed with benzoate or propionate identify the binding site for the organic acids which are required for the haloperoxidase activity. Based on these complexes and on the structure of an inactive variant, a reaction mechanism is proposed for the halogenation reaction with peroxoacid and hypohalous acid as reaction intermediates. Comparison of the structures suggests that a specific halide binding site is absent in the enzymes but that hydrophobic organic compounds may fit into the active site pocket for halogenation at preferential sites.

Amino Acid Sequence↗
PubMed1998

Detection of staphylococcal genes directly from cerebrospinal and peritoneal fluid samples using a multiplex polymerase chain reaction.

A multiplex polymerase chain reaction (PCR) that can simultaneously detect eubacterial isolates and the methicillin-susceptibility of staphylococcal isolates from cerebrospinal and peritoneal fluid samples was compared to conventional microbiological methods. Using conventional methods, bacteria were isolated from 8% (29/350) of the cerebrospinal fluid samples and from 5% (3/60) of the peritoneal fluid samples. All isolates except two Staphylococcus epidermidis isolates were also detected using the multiplex PCR. Coagulase-negative staphylococci and Staphylococcus aureus were correctly identified using both methods. The multiplex PCR can rapidly and simultaneously detect eubacteria, and the methicillin susceptibility of staphylococci from samples containing > or = 10(2) cfu/ml of bacteria.

Ascitic Fluid↗
PubMed1998

Drinking water fluoridation: bone mineral density and hip fracture incidence.

The role of drinking water fluoride content for prevention of osteoporosis remains controversial. Therefore, we analyzed the influence of drinking water fluoridation on the incidence of osteoporotic hip fractures and bone mineral density (BMD) in two different communities in eastern Germany: in Chemnitz, drinking water was fluoridated (1 mg/L) over a period of 30 years; in Halle, the water was not fluoridated. BMD was measured in healthy hospital employees aged 20-60 years (Halle: 214 women, 98 men; Chemnitz: 201 women, 43 men, respectively) using dual-energy X-ray absorptiometry. Hip fractures in patients > or = 35 years admitted to the local hospitals in the years 1987-1989 were collected from the clinic registers. There was no difference in age, anthropometric, hormonal, or lifestyle variables between the two groups. Mean fluoride exposure in Chemnitz was 25.2 +/- 7.3 years. No correlation was found between fluoride exposure and age-adjusted BMD. We found no significant difference in spinal or femoral BMD between subjects living in Halle and Chemnitz [lumbar spine: 0.997 +/- 0.129 (g/cm2) vs. 1.045 + 0.171 (g/cm2), p = 0.08, for men; 1.055 +/- 0.112 (g/cm2) vs. 1.046 +/- 0.117 (g/cm2), p = 0.47, for women]. The fracture incidence showed an exponential increase with aging in men and women with an incidence about 3.5 times higher for women. In Chemnitz, we calculated an age-adjusted annual incidence of 142.2 per 100,000 for women and 72.5 per 100,000 for men, respectively. In Halle, the incidences were 178.5 per 100,000 for women and 89.2 per 100,000 for men. There was a lower hip fracture incidence after the age of 85 in women in Chemnitz (1391 per 100,000 in Chemnitz vs. 1957 per 100,000) in Halle, p = 0.006). Using the age-adjusted incidences, significantly fewer hip fractures occurred in Chemnitz in both men and women. In conclusion, our study suggests that optimal drinking water fluoridation (1 mg/L), which is advocated for prevention of dental caries, does not influence peak bone density but may reduce the incidence of osteoporotic hip fractures in the very old.

Adult↗
PubMed1998

Alpha1-antitrypsin alleles and phenotypes in patients with inflammatory bowel disease.

BACKGROUND: Several studies suggest an imbalance of protease activation and inhibition in inflammatory bowel disease. Alpha1-Antitrypsin (AAT), one protease inhibitor of paramount importance, exists in numerous subtypes, some of them representing deficient phenotypes. The present study evaluated the prevalence of AAT-alleles and phenotypes in patients with inflammatory bowel disease. METHODS: The study population comprised 74 patients with Crohn's disease and 61 patients with ulcerative colitis. Isoelectric focusing was used for AAT subtyping. The prevalence of AAT alleles and phenotypes was compared with the frequency in 752 healthy unrelated controls. RESULTS: The rare phenotype M2F was detected in one patient with ulcerative colitis. No further significant differences in the distribution of AAT alleles or phenotypes between patients with inflammatory bowel disease and the healthy controls were observed. CONCLUSION: The low prevalence of deficient AAT subtypes does not point towards a contribution of AAT deficiency in the pathophysiology of IBD.

Adolescent↗
PubMed1998

Relationship between ciprofloxacin, ofloxacin, levofloxacin, sparfloxacin and moxifloxacin (BAY 12-8039) MICs and mutations in grlA, grlB, gyrA and gyrB in 116 unrelated clinical isolates of Staphylococcus aureus.

The in-vitro activities of five fluoroquinolones were tested against 70 ciprofloxacin-resistant and 46 ciprofloxacin-susceptible unrelated isolates of Staphylococcus aureus. All 116 S. aureus isolates were studied for the presence of mutations in the grl and gyr loci. The order of efficacy of the fluoroquinolones tested, from least to most active, was: ciprofloxacin, ofloxacin, levofloxacin, sparfloxacin and moxifloxacin (BAY 12-8039), in response to all characterized mutations in grlA, grlB, gyrA and gyrB. Moxifloxacin was active against most S. aureus isolates tested (MIC90 = 1 mg/L for ciprofloxacin-resistant isolates) and was less influenced by known mutations.

Anti-Infective Agents↗
PubMed1998

The prevalence of low- and high-level mupirocin resistance in staphylococci from 19 European hospitals.

The topical agent mupirocin plays a crucial role in strategies designed to control outbreaks of methicillin-resistant Staphylococcus aureus. The extent of high- or low-level mupirocin resistance amongst S. aureus from European hospitals is not known. Six hundred and ninety-nine S. aureus and 249 coagulase-negative staphylococci (CNS) derived from blood, hospital-acquired pneumonia or skin and soft tissue infections from 19 European hospitals were tested for susceptibility to mupirocin and oxacillin. Methicillin sensitivity was found in 72% and 32% of S. aureus and CNS, respectively. High-level mupirocin resistance was detected in 1.6% of S. aureus and 5.6% of CNS isolates, while low-level mupirocin resistance was detected in 2.3% of S. aureus and 7.2% of CNS isolates. Amongst S. aureus, methicillin-resistant isolates were twice as likely to have high- or low-level mupirocin resistance. This difference was less pronounced in CNS. No relationship was found between the site of infection and prevalence of mupirocin resistance. High- and low-level mupirocin resistance was detected amongst staphylococci from 10 and 16 of the hospitals studied, respectively. To maintain the relatively low prevalence of mupirocin resistance in Europe amongst both S. aureus and CNS, the prudent use of mupirocin restricted to defined infection control strategies should be emphasized.

Anti-Bacterial Agents↗
PubMed1998

The effect of reserpine, an inhibitor of multidrug efflux pumps, on the in-vitro activities of ciprofloxacin, sparfloxacin and moxifloxacin against clinical isolates of Staphylococcus aureus.

In Staphylococcus aureus, in addition to mutations in the grl and gyr gene loci, multidrug efflux pumps like NorA contribute to decreased fluoroquinolone susceptibility. Efflux pumps can be inhibited by the plant alkaloid reserpine, which, at 20 mg/L, reduced sparfloxacin, moxifloxacin and ciprofloxacin IC50s and MICs by up to four-fold in 11, 21 and 48 of the 102 unrelated clinical isolates tested, respectively. The effect was less pronounced with the hydrophobic drugs sparfloxacin and moxifloxacin than with the hydrophilic drug ciprofloxacin and was stable in all 25 clonally related isolates tested.

Anti-Infective Agents↗
PubMed1998

Development of a multiplex-PCR for direct detection of the genes for enterotoxin B and C, and toxic shock syndrome toxin-1 in Staphylococcus aureus isolates.

As well as conventional methods such as immunodiffusion, ELISA, or agglutination for the detection of toxin production in Staphylococcus aureus, amplification techniques like PCR allow a very sensitive and specific identification of the genes responsible for enterotoxin B and C, and TSST-1 production. These toxins might be a cause of the toxic shock syndrome (TSS). For that reason an easy and quick test system for determining the toxin production pattern of S. aureus isolates is desirable so that strains suspected to be toxin producers may be identified much faster and easier. In the present investigation, a new multiplex-PCR method was used that allowed single bacterial colonies grown on agar plates to be used directly in the PCR assay without preceding preparation. This procedure generated information concerning the presence of seb, sec-1 and tst genes within 4 h in a single test. To analyse the sensitivity and the specificity of this procedure, 100 methicillin-resistant S. aureus (MRSA), 50 coagulase-negative staphylococci and 50 other eubacterial isolates were tested initially with sets of single primer pairs followed by a combined multiplex-PCR. Results of this amplification technique were compared to a conventional and widely used method for toxin detection, reversed passive latex agglutination (RPLA). With the RPLA assay results as the basis, sensitivity and specificity of the seb and tst primer sets were 100%, whereas sensitivity and specificity of the sec-1 primer set were 100% and 82%, respectively. With the sec-1 primer set, two isolates were identified as carrying the corresponding toxin gene although the RPLA test did not show any detectable toxin. The multiplex-PCR rapidly generated reliable information concerning the toxin-producing capacity of staphylococcal strains and could be easily integrated into a multiplex procedure described previously. The latter enabled the identification of specific PCR products for eubacteria and staphylococci as well as the detection of the coa and mecA genes.

Bacterial Toxins↗
PubMed1998

Typing of methicillin-resistant Staphylococcus aureus isolates from Düsseldorf by six genotypic methods.

Nosocomial infections caused by methicillin-resistant Staphylococcus aureus (MRSA) represent an increasing problem in hospitals. Quick and reliable typing methods are required to obtain information about the relatedness of MRSA isolates and to allow faster implementation of appropriate infection control measures. This investigation describes the distribution of MRSA isolates from 11 hospitals in the Düsseldorf region of Germany, and the ability of six different genotypic typing techniques -- pulsed-field gel electrophoresis (PFGE), random amplification of polymorphic DNA (RAPD), 16S-23S rDNA spacer amplification, protein A-gene PCR, PCR characterisation of the hypervariable region (HVR) adjacent to mecA, and coagulase gene-PCR -- to detect different unrelated types. Of 7814 S. aureus isolates tested, 489 (6.3%) were MRSA, of which 183 were selected for subsequent molecular analyses on the basis of being the first MRSA isolated from colonised or infected patients. Larger hospitals had a higher incidence of MRSA and a greater variability in genotypes than smaller hospitals. All methods confirmed the presence of two main clonal types. The ability of techniques to detect different unrelated types was found to be as follows: PFGE, 28 types; 16S-23S rDNA spacer-amplification, 10 types; RAPD, nine types; protein A-gene PCR, five types; HVR-PCR, five types; and coa gene-PCR, two types. Combination of PFGE and one other PCR-based method (spacer-amplification, RAPD or protein-A gene PCR) provided the best resolution of types and allowed the identification of subtypes. Similar molecular types were identified with international MRSA isolates. Although PCR-based techniques have the advantage of rapid performance and easy handling, their discriminatory capacity is inferior compared to the more labour intensive PFGE.

Bacterial Typing Techniques↗
PubMed1998

Characterization of grlA, grlB, gyrA, and gyrB mutations in 116 unrelated isolates of Staphylococcus aureus and effects of mutations on ciprofloxacin MIC.

One hundred sixteen unrelated clinical isolates of Staphylococcus aureus (70 ciprofloxacin resistant and 46 ciprofloxacin susceptible) from eight countries were studied for the presence of mutations in the grlA, grlB, gyrA, and gyrB gene loci. Two mutations within grlA (located at codons 80 and 84) and two mutations within gyrA (located at codons 84 and 88) were clearly associated with ciprofloxacin resistance, although other mutations detected within the four genes studied may also contribute to decreased susceptibility.

Anti-Infective Agents↗
PubMed1998

[Cleavage and biotransformation of the central muscle relaxant chlormezanone].

Chlormezanone, a chiral centrally acting muscle relaxant, will be cleaved at its S-C-1 bond by an autoprotolytic process. The optimum of chemical stability exists between pH 2 up to pH 9 with a maximum at pH 7.4. The plasma half life at 37 degrees C is 76 h. Enzymes do attack the products of cleavage namely 4-chlorobenzaldehyde and 2-carboxyethane-sulfinic-acid-N-methyl-amide. The main metabolite in urine is 4-chlorohippuric acid in the range of up to 70% of the oral administered dose to humans. No cytochrome P-450 is engaged in the cleavage of the S-C-bond.

Biotransformation↗
PubMed1997

[From the history of electrocardiography].

The basis of electrocardiography was established in the innovative years between 1850 and 1930. Men like Waller, DuBois-Reymond, and Einthoven were the innovators of what we today recognize as modern electrocardiography. Others, like Lewis and Bedford, introduced analysis of cardiac arrhythmias, of the S-T segment and the QRS complex. The article gives an overview of this innovative period and its instrumentation.

Electrocardiography↗
PubMed1997

[Medical equipment--errors, causes and risks].

Development in technology has introduced advanced technological apparatus into the health care sector. New technology has led to increased possibilities in diagnostics and treatment, but it also represents a substantial risk. A survey at the Lillehammer Hospital showed a relatively high rate of apparatus failure. However, only in a few cases was this of any consequence to the patient or the operator. The survey showed that preventive maintenance reduces the failure rate and that operator training and user checks reduce the risk related to medical apparatus.

Equipment Failure↗
PubMed1997

HIV-infected individuals with the CCR delta32/CCR5 genotype have lower HIV RNA levels and higher CD4 cell counts in the early years of the infection than do patients with the wild type. Copenhagen AIDS Cohort Study Group.

The relations among serum HIV RNA levels, CD4 cell counts, presence of the mutant CCR5-allele in heterozygous form, and clinical outcome was analyzed in 96 patients from the Copenhagen AIDS Cohort. In the early years of the infection, patients with the CCR5 delta32/CCR5 genotype had significantly lower HIV RNA levels (p = 0.005) and higher CD4 cell counts (p < 0.005) than did patients homozygous for the normal allele. The long-term clinical benefit of being heterozygous is small and cannot solely explain the large interpatient variation in progression rates. The beneficial effect of being heterozygous seems to be mediated by events in the early stages of the HIV infection.

CD4 Lymphocyte Count↗