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Biomedical subjects

H Höjer

Publications and source records attributed to H Höjer.

26 records · Page 2Linked to original sources
PubMed1977

A 14-month study of severe non-wound infectious complications in general surgery.

A retrospective study of serious non-wound infectious complications in general surgery during at 14-month period is reported. A prospective study on wound infections in available from the same institution and period. Septicemia, intraabdominal and intrathoracal abscesses and rare cases of osteomyelitis occurred in 1.3% of all treated patients, whereas postoperative wound infection developed in 7.5% of primarily non-infected patients. Mortality was significantly higher among patients with serious infections than in all patients nursed during the same period. Severe postoperative infectious complications was in fact the third most common cause of death and accounted for 14% of the mortality of the clinic. This rate rises to close to 50% when death from incurable disease is excluded. Septicemia carried a significantly higher mortality rate than intraabdominal abscesses. The risk of a serious infection developing was significantly higher in operations on the small or large intestine than after appendectomies or biliary operations. Gram negative bacteria dominated, especially in cases with a fatal outcome. Contributing factors such as malignancy, preoperative infection or macroscopic peroperative wound soiling, were more common in patients where a serious infectious complication developed postoperatively.

Abscess↗
PubMed1976

Concentration of doxycycline in bowel tissue and postoperative infections.

An investigation on the relation between the effect of doxycycline as prophylactic antibiotic in colonic surgery and levels of doxycycline in serum and bowel tissue with reference to MIC-values of bacterial strains isolated at surgery or after postoperative septic complications is presented. 200 mg doxycycline orally 4-6 hours preoperatively resulted in a serum concentration of 4.0 +/- 0.3 mug/ml at the onset of operation. Tissue samples removed at surgery were assayed for doxycycline. High levels were observed in bowel tissue, ileum 7.5 +/- 1.2 mug/ml and colon 3.9 +/- 0.3 mug/ml. The effects of dosage, time of administration and bowel pathology on tissue levels are discussed. Aerobic and anaerobic bacterial strains were tested for in vitro susceptibility to doxycycline using a standardized disc-diffusion method according to Eriksson and Sherris. 75% of the strains belonged to sensitivity groups 1 and 2 (sensitive-fairly sensitive). That is, MIC-values in 75% of the strains were below the average serum and intestinal tissue concentration during the operation. The implications of these results are that the dosage and time of administration of the drug must be adjusted so that serum and tissue levels are adequate during surgery.

Administration, Oral↗
PubMed1976

In-vitro effect of doxycycline on levels of adenosine triphosphate in bacterial cultures. Possible clinical applications.

Short-term effects of doxycycline on viability and levels of intracellular ATP in bacteria were studied. Inhibition of growth by doxycycline was reflected in a corresponding inhibition of the accumulation of intracellular ATP which was clearly demonstrable within 1-2 hours. The effects of doxycycline on intracellular ATP were dose-dependent and the use of ATP assays for quantitation of antibiotics in serum is discussed. In 45 clinical isolates exposed to doxycycline a positive correlation was found between antibiotic-induced inhibition of intracellular ATP levels and inhibitory zone diameters with the disc diffusion method, indicating possible clinical applications in rapid susceptibility testing.

Adenosine Triphosphate↗
PubMed1976

In-vitro effects of Candida albicans of amphotericin B combined with other antibiotics. Preliminary observations.

The effect of amphotericin B combined with rifampicin or doxycycline on growth, oxygen consumption and ATP levels in cultures of Candida albicans, was studied. Alone, neither rifampicin nor doxycycline--even at high concentrations--affected the growth of the test organism. However, when combined with a concentration of amphotericin B which alone did not affect the growth of C. albicans, a pronounced fungistatic effect was obtained with therapeutically attainable concentrations of the drugs.

Adenosine Triphosphate↗
PubMed1976

Systemic prophylaxis with doxycycline in surgery of the colon and rectum.

A prospective randomized double-blind study on the effects of doxycycline as prophylactic antibiotic in elective colonic surgery is presented. 82 patients were evaluated. 39 were treated and 43 were controls. Mechanical cleansing of the bowel and a low residue diet for two days was routine. 200 mg doxycycline or placebo (2 capsules) were given orally 4-6 hours preoperatively and 100 mg (1 capsule) for 5 postoperative days. A significantly lower incidence of wound sepsis, intraabdominal complications and septicemia was registered in the doxycycline compared to the control group, 12.8 and 44.2 per cent respectively. After proctectomies, infections in the perineal field occurred in 3/9 and 5/10 cases in respective groups. In the doxycycline group, however, they were the only complication, whereas among the controls they were generally combined with infections in the abdominal field, 4/5. Peroperative contamination seemed to carry easier consequences in the doxycycline group. The results are discussed further. Doxycycline appears to be an excellent antibiotic for peroperative and short postoperative prophylactic use in potentially contaminated abdominal operations, not only because of its observed effects, but also when its negligible tendency to cause adverse reactions is taken into consideration. Bacterial cultures, concentrations of doxycycline in serum and tissues and their relation to infections will be accounted for and discussed in a separate paper.

Bacteriological Techniques↗
PubMed1976

Prophylactic cephalothin in gastrointestinal surgery.

A prospective study was carried out to evaluate the effect of a strictly standardized, short-term prophylactic treatment with cephalothin (Keflin) on the incidence of postoperative wound infections in gastrointestinal surgery. Achieved levels of cephalothin activity in serum and interstitial water were studied, and the sensitivity of isolated bacteria at the end of operation and from septic wounds was defined. Patients were divided at random into treatment and control groups. The treatment group received 2 g cephalothin at the induction of anesthesia and another 2 g, 5 and 10 hours after the primary infusion. The control group remained untreated. The rapid infusion of 2 g cephalothin resulted in high initial serum levels, which declined rapidly. Equilibration between intraand extravascular compartments occurred about 60-80 minutes after start of infusion. At that time the infused dose resulted in a cephalothin level of about 30 mug/ml in ECV and plasma, or about 30% of the initial concentration. Despite the prophylactic infusion of cephalothin, the frequency of wound infection in treated patients was the same as in the controls. Subdivision of the material according to type of surgery performed did not reveal any difference between untreated patients and controls. No shift towards cephalothin-resistant strains was observed in isolates from septic wounds in the treatment group.

Adolescent↗