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Biomedical subjects

F Mosimann

Publications and source records attributed to F Mosimann.

At least 73 records · Page 4Linked to original sources
PubMed1994

Herpes simplex esophagitis after renal transplantation.

This paper describes five renal transplant recipients, out of a series of 221 consecutive patients, who developed herpes simplex esophagitis. This opportunistic infection presented as odyno- and/or dysphagia. It occurred during or shortly after treatment of acute cellular rejection episodes with high doses of steroids and, in four cases, of anti-lymphocyte globulins. The infection responded to acyclovir in all patients. We conclude from these observations that herpes esophagitis occurs during periods of intensive immunosuppression. Because its endoscopic manifestations are variable, biopsies and cultures are essential to reach the diagnosis. Prevention may be possible by avoiding transplantation from a seropositive donor to a negative recipient and by prophylactic oral acyclovir.

Acyclovir↗
PubMed1994

[Liver transplantation and pregnancy: 1994 perspectives].

The authors report a case of pregnancy in a 24-year-old, gravida-3, para-1 patient who had previously undergone liver transplantation for alveolar echinococcosis. Pregnancy and delivery were uneventful with no obstetrical or liver complications. Pregnancy seems to have little effect on liver transplants and rejection is seldom observed. Primary maternal complications are hypertension, preeclampsia, anemia and hyperbilirubinemia. Primary fetal complications include premature delivery and growth retardation. The mode of delivery depends on the obstetrical situation. Cyclosporin may be used during pregnancy. The risk of breastfeeding has not been clearly established. Pregnancy after liver transplantation is possible after 9 to 12 months but requires strict multidisciplinary surveillance. Barrier methods remain the preferred method of contraception for liver transplant patients.

Adult↗
PubMed1994

Intramural haematoma of the oesophagus complicating sclerotherapy for varices.

A patient is described who developed an intramural haematoma of the oesophagus shortly after variceal endoscopic sclerotherapy. This unusual complication is best imaged by computed tomography or nuclear magnetic resonance and needs conservative treatment. Resolution usually occurs spontaneously and may result in eradication of the varices.

Esophageal Diseases↗
PubMed1994

["Standing waves": differential diagnosis of fibromuscular dysplasia].

We report two recent observations of an angiographic artefact called "standing waves". It results in the same characteristic beaded pictures than fibromuscular dysplasia. It is induced by the angiography catheter and is related to the speed of injection. The possible occurrence of this artefact should be borne in mind whenever the films show dysplastic lesions in more than one artery.

Adult↗
PubMed1994

[Systematic use of a "swan neck" catheter for peritoneal dialysis: first evaluation].

We inserted a "swan neck" peritoneal dialysis catheter in 26 patients between January 1991 and December 1992. We report our results in the 24 patients that we were able to follow: they were satisfactory but the exit-site infection rate was too high. Postoperative care of the catheter is of paramount importance to prevent such complications.

Adult↗
PubMed1994

[Liver transplantation with partial clamping of the inferior vena cava: preliminary experiences].

Caval reconstruction during orthotopic liver transplantation is usually achieved by two end-to-end anastomoses and extracorporeal veno-venous bypass. We report our preliminary experience with a new technique by lateral clamping of the recipient's cava and a side-to-side caval anastomosis without by-pass. This new technique appears safe and shortens the operative time.

Anastomosis, Surgical↗
PubMed1993

[Liver transplantation. Facts and trends].

The aim of this article is to orientate the non-specialist in the field of liver transplantation. The main indications and contraindications are reviewed. The surgical technique is briefly illustrated and the postoperative follow-up is described. Several points have been raised on the present and future trends of this technology which may give the reader some food for thought. The authors state that liver transplantation is too infrequently performed in Switzerland. Some candidates for the operation are not identified, whilst others are referred too late to a transplantation center.

Follow-Up Studies↗
PubMed1992

[Value of simultaneous determination of cyclosporin blood levels using specific and nonspecific methods in liver transplantation].

Cyclosporine's narrow therapeutic window and the large inter- and intra-individual variation of its pharmacokinetics require therapeutic monitoring. Cyclosporine is metabolized in the liver and excreted with its metabolite into the bile. An accumulation of metabolites occurs in liver dysfunction, leading to a high cyclosporine blood concentration when measured by a non-specific method (polyclonal antibodies). Specific methods (HPCL, monoclonal antibody) are therefore recommended by some authors. We evaluated the potential usefulness of simultaneous cyclosporine determination by a non-specific (fluorescent polarisation TDx, polyclonal antibodies) and a specific method (I125-RIA, monoclonal antibody). 10 patients were followed from 51 days to 32 months after hepatic transplantation. 2 patients who showed no graft rejection presented a polyclonal antibodies/monoclonal antibody ratio below or equal to 4 throughout their evolution. Other patients presented a rise of this ratio during periods of liver dysfunction, particularly in acute graft rejection. When bilirubin concentrations are plotted versus this ratio, an hysteresis is present during periods of acute rejection, but not during an episode of histological hepatitis. The same holds true for alkaline phosphatase and gamma-GT. These data suggest that this ratio could be a sensitive test for early detection of rejection. Simultaneous cyclosporine blood determination with specific and nonspecific methods may be useful in the follow-up of liver-transplanted patients.

Adult↗
PubMed1992

Prophylaxis and treatment of infections complicating abdominal surgery.

The suitability of commonly used antimicrobial regimens for prophylaxis in abdominal surgery and treatment of intra-abdominal sepsis is discussed. These various therapies are often limited in their usefulness by the range of microorganisms against which they are effective and thus, to extend the antimicrobial cover, agents may be combined. Some forms of therapy may produce adverse effects in susceptible patients, thus limiting their use to certain groups, or there may be cost constraints. Beta-lactamase-inhibiting compounds appear to offer an optimal combination of a broad spectrum of activity against aerobic and anaerobic microorganisms, minimal toxicity and reasonable cost.

Abdomen↗
PubMed1992

[Diagnosis of acute pancreatitis].

The diagnosis of acute pancreatitis is based on clinical examination as described by Fitz in 1889 and on laboratory tests. Amylase and lipase levels in the blood are the most useful of the latter. The severity of acute pancreatitis is classically graded by the Ranson and Imrie scores: both systems are specific for acute pancreatitis but request 48 hours for a prognosis to be defined. Non specific prognostic scores such as APACHE II and SAPS avoid such a delay. Recent studies suggest that single biologic markers such as C-reactive protein and trypsinogen activation peptides may soon allow a simple and early assessment of the prognosis. In the meantime, CT is the reference diagnostic method whenever pathologic proof of the disease is lacking; such imaging strengthens the prognostic value of the bioclinical scores.

Acute Disease↗