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Biomedical subjects

F Waldvogel

Publications and source records attributed to F Waldvogel.

At least 19 recordsLinked to original sources
PubMed1992

[Internal medicine today--and tomorrow?].

Internal medicine has recently undergone major changes, which have created--among others--4 feelings of alienation among physicians: first, the internist--initially an observer of clinical signs, and later laboratory-assisted--has now become operator-assisted with modern technology in imaging and other technologies assisting him by giving him not the essence, but the interpretation of the gathered information; second, the dialogue between basic biomedical research and the bedside clinician has been interrupted by the creation of a new language in molecular genetics, to which he has no access any more; third, modern biotechnology is rapidly creating an unlimited number of new biological therapeutic modalities, giving the internist too many therapeutic options which he can no longer master. Fourth, the formerly direct, bipolar relationship between patient and physician has been extended to a triangular relationship between patient, physician and an institution (hospital administration, public health authority, health insurance). In order to solve these problems, internal medicine has several options. First, maintaining the dialogue in research across subspecialties by creating a group of full time clinical investigators, with training in basic molecular and cellular biology, who can be the interface between modern molecular genetics and clinical internal medicine; and second, developing new clinical investigators to evaluate our diagnostic and therapeutic strategies with a logical and scientific methodology: patient care analysis, health care research, medical outcome evaluation and quality assessment are all disciplines which will link the various fields of internal medicine into a tight network. To do this, the Swiss Society of Internal Medicine has to modify its structures, to become a scientific and a professional organization, cognizant of the evolution of medicine within the European scene.

Adolescent↗
PubMed1991

[Variations in body weight and feeding behavior in internal medicine].

We have identified an eating disorder in 13% of women hospitalized on a medical ward for various reasons. These as well as obese patients undergo wide fluctuations of weight sometimes exceeding 30% of their present weight. Surprisingly, even in the absence of eating disorders, the changes in weight during adulthood are marked (22% of present body weight). Weight history should be included systematically in the medical history, since it can underscore concern over weight or even an unrecognized eating disorder.

Adolescent↗
PubMed1991

[Meningitis in adults in Geneva. Review of 257 cases].

We review the 257 patients hospitalized for meningitis in the Cantonal University Hospital, Geneva between 1st January 1980 and 31st December 1986. 104 patients had acute bacterial meningitis (32 Str. pneumoniae, 21 N. meningitidis, 10 Listeria monocytogenes, 8 streptococci, 5 H. influenzae, 5 staphylococci, 4 gram negative bacilli and 19 without identified bacteria), 124 patients had viral meningitis and 29 meningitis of other etiologies (6 tuberculous meningitis, 2 fungal meningitis, 1 leptospiral meningitis, 5 neoplastic meningitis--one already counted because of a meningitis due to Staph. epidermidis--2 meningitis consecutive to a meningeal irritation, 4 already treated meningitis of undetermined etiology, 2 chronic meningitis and 8 meningoencephalitis). The total mortality was 14.4%. It was zero in viral meningitis and 28% in bacterial meningitis (47% in cases of Str. pneumoniae, 5% in cases of N. meningitidis, 20% in cases of Listeria monocytogenes, 38% in cases of streptococci, 0% in cases of H. influenzae, 60% in cases of staphylococci, 50% in cases of gram negative bacilli, 16% in cases of unidentified bacteria). The striking difference in mortality emphasizes the importance of recognizing a bacterial etiology in order to institute antibiotic therapy as soon as possible. The delay between admission and lumbar puncture averaged 15 hours (range 0.25-96 h) in patients with acute bacterial meningitis and 6.3 hours (0.5-80 h) in patients with viral meningitis. The delay between admission and institution of the antibiotics averaged 5.3 hours (1-48 h) in cases of acute bacterial meningitis and 4.8 hours (0.5-48 h) in cases of viral meningitis. A better clinical workup may provide a reliable diagnosis sooner. In the collective with bacterial and viral meningitis headaches, fever or nuchal rigidity were present in over 80% of the cases. The following features were significantly associated with a bacterial etiology: age over 30 years, alcoholism, concomitant neoplasm, cough, coma, pulmonary rales, new neurological signs or petechia. At least one of these 4 latter signs was present in more than 70% of the cases with acute bacterial meningitis compared to 6% in cases of viral meningitis. Thus the clinical presentation alone serves to recognize the meningitis and to differentiate between a bacterial or viral etiology, thus permitting an immediate therapeutic decision without waiting for complementary investigations. The 104 patients with acute bacterial meningitis were treated with antibiotics: 60 with penicillin, 17 with ampicillin and 26 with other antibiotics; one case did not receive antibiotics. More than the half of the cases with viral meningitis have got antibiotics (52%).

Adolescent↗
PubMed1989

[Drug interactions of midazolam].

Midazolam is a short-acting benzodiazepine with a short half life (1.5-2.5 h) due to intense biotransformation by liver monooxygenases. Anecdotal clinical reports have mentioned a wide interpatient variability in its duration of action. We investigated by in vitro screening factors that could interfere with the rate of midazolam biotransformation (drug-drug interactions). Metabolite production (1'-and 4-OH-midazolam) was monitored in human liver microsomes. Midazolam hydroxylations are inhibited by several drugs (i.e. erythromycin, phenothiazine-type neuroleptics, cyclosporine). The clinical relevance of these drug interactions is illustrated by the example of a patient treated with amiodarone, erythromycin and midazolam during anesthesia. Midazolam-induced sleep lasted about 6 days due to inhibition of its biotransformation by concomitant drug treatment.

Biotransformation↗
PubMed1988

[EEG recordings in 19 cases of AIDS with encephalic involvement].

Between 1983 and 1987, 19 patients presenting with encephalic involvement of AIDS had an EEG recording during the early neurological examination. In 8 patients, EEGs were repeated 1 to 11 times during the course of the disease. All recordings were abnormal. A good EEG correlation existed with clinical, virological and bacteriological (SF), radiological, and histological data (10 cases). EEG recordings are useful to study the encephalic pathology of AIDS, not only for its secondary, but even more for its primary involvement.

Acquired Immunodeficiency Syndrome↗
PubMed1987

[Reversible pancytopenia and cardiac murmur].

In this clinical-pathological conference the case of a patient with aplastic anemia is presented who recovered after treatment with prednisone and antilymphocyte serum. The patient's clinical course was however complicated by persistent fever and panuveitis. This was followed by acute mitral insufficiency and left ventricular failure, leading to the patient's death.

Acute Disease↗
PubMed1987

[Osteomyelitis].

Explore the source record for details and available documents.

Anti-Bacterial Agents↗
PubMed1987

Early termination of a prospective, randomized trial comparing teicoplanin and flucloxacillin for treating severe staphylococcal infections.

In a prospective, randomized trial, teicoplanin (at a 400-mg intravenous loading dose followed by 200 mg/day intravenously or intramuscularly) was compared with flucloxacillin (8 g/day) in patients with severe staphylococcal infections. Teicoplanin proved unsatisfactory for the following reasons: failures or relapses were more frequent in the teicoplanin group, and blood levels were difficult to predict and tended to be low 24 hr after the loading dose. Future trials with this agent should use much-higher doses.

Adult↗
PubMed1987

Role of bacterial exopolymers and host factors on adherence and phagocytosis of Staphylococcus aureus in foreign body infection.

Using a previously developed guinea pig model of foreign body infection, we examined ultrastructural and functional surface alterations of Staphylococcus aureus strain Wood 46 during the early phase of infection. Exopolymer-free bacteria were prepared and inoculated into subcutaneously implanted tissue cages. After three hours, the bacteria showed abundant capsular and intercellular exopolymers, which were visualized by transmission electron microscopy. Exopolymers were also produced by S. aureus exposed in electron microscopy. Exopolymers were also produced by S. aureus exposed in vitro to fluid from the tissue cage. In contrast, human serum albumin prevented exopolymer production by S. aureus. The influence of exopolymers on the susceptibility of S. aureus to ingestion and phagocytic killing by neutrophils was tested in vitro and found to be negligible. Furthermore, adherence of S. aureus to fibronectin-coated surfaces was unaffected by the presence or absence of exopolymers. Thus, in our experimental model, exopolymers are produced early during the onset of infection, but they have little impact on adherence and phagocytosis.

Animals↗
PubMed1984

Low levels of functional of alpha 1-proteinase inhibitor in the promotion of C3-cleavage by granulocyte-neutral proteases in pleural empyema.

It has been suggested that C3 breakdown by granulocyte-neutral proteases in pleural empyemas may be related to a decreased inhibitor potential for these enzymes. In the present study it was shown that in 17 infected pleural effusions, high proteolytic activity on 125I-labeled C3 (16.3% +/- 4.4%) correlated with low functional levels of alpha 1-proteinase inhibitor (alpha 1-PI), as determined by trypsin-inhibitory capacity (56.2 +/- 20.1 IU/ml; rs = -0.97, P less than .001), whereas in 18 sterile pleural effusions there was no such correlation (125I-labeled C3 cleavage, 2.2% +/- .2%; trypsin-inhibitory capacity, 192.6 +/- 26.7 IU/ml). However, alpha 1-PI and alpha 2-macroglobulin protein concentrations in infected and sterile effusions (as measured by immunodiffusion) were similar. Fifteen strains of three bacterial species--Streptococcus pneumoniae, Pseudomonas aeruginosa, and Proteus mirabilis--isolated from patients with pneumonia or empyema inactivated the elastase-inhibitory capacity of alpha 1-PI in vitro. These results show that in empyemas functional levels of alpha 1-PI were too low to inactivate granulocyte elastase and that some bacterial species may contribute to the low inhibitor potential of infected pleural fluid by direct alpha 1-PI inactivation.

Blood Proteins↗
PubMed1983

Cloning and analysis of the K1 capsule biosynthesis genes of Escherichia coli: lack of homology with Neisseria meningitidis group B DNA sequences.

Genes coding for production of the K1 polysaccharide capsule of Escherichia coli have been cloned. Complementation, insertion, and deletion analyses were used to localize the K1 genes and demonstrated that a minimum of 9 kilobases of DNA split into at least two gene blocks is involved in synthesis and assembly of the capsule. One of the gene blocks is responsible for biosynthesis of the polysaccharide, and the other is responsible for extracellular appearance of capsular material. Using cloned K1 genes as probes in Southern blot experiments, we detected homology to DNA from strains of E. coli capsular types K92, K7, and K100. In contrast, no homology was apparent between K1 genes and DNA from meningococcus group B, although the K1 and group B capsules are chemically and immunologically identical.

Chromosome Mapping↗
PubMed1983

Bacteriological study of amniotic fluid during labor.

Amniotic fluid from 207 women in labor was analysed at the time of artificial rupture of membranes or by amniocentesis. The following organisms were identified in concentrations of more than 1 000/ml: Staphylococcus aureus (1), Propionibacterium (1), E. coli (1), group B Streptococci (3), Lactobacilli (16). The 6 patient-carriers of pathogens became infected as did 4 of their babies. Leukocyte counts and LDH levels performed on amniotic fluid did not correlate with the appearance of symptoms of infection. Quantitative bacteriology of amniotic fluid seems to be of value in identifying patients at high risk of developing endometritis and/or neonatal sepsis.

Amniotic Fluid↗
PubMed1983

[Mycotic aneurysms of the intrapulmonary arteries: unusual manifestation of right-sided endocarditis].

We report the case of a 27 year old man admitted to hospital for investigation of radiological opacities of recent origin. A diagnosis of mycotic aneurysms was made on a surgical biopsy. Although a right sided endocarditis could not be detected clinically, a trial of antibiotic therapy was instituted. However, no improvement occurred. The patient died, following a massive pulmonary haemorrhage. The necropsy revealed an active right sided endocarditis with multiple aneurysms of the intra-pulmonary arteries.

Adult↗
PubMed1979

[Hemoglobin D Punjab. Apropos of 2 families].

Two families who are carriers of hemoglobin DPunjab in the heterozygous state are described. This is the first time hemoglobin DPunjab has been reported in Switzerland. The propositus of the first family had two periods of acute hemolysis, probably drug-induced, which were followed by reversible renal complications and which led to the discovery of the hemoglobin. Study of the second family was undertaken because of anemia in one of its members.

Aged↗