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Biomedical subjects

H R Baumann

Publications and source records attributed to H R Baumann.

At least 19 recordsLinked to original sources
PubMed1993

[Diagnosis and therapy of endobronchial and tracheal hamartomas].

Endobronchial hamartomas are a tenth as frequent as the usually asymptomatic intrapulmonary hamartomas. We report on 7 patients. 2 men and 3 women had an endobronchial hamartoma. In one patient multiple endobronchial hamartomas were found in the left upper lobe. In a 56-year-old patient with an 8-year history of shortness of breath, cough and several episodes of pneumonia and acute onset of respiratory failure, a tracheal hamartoma was diagnosed. Frequently, endobronchial hamartomas can be resected without loss of lung tissue. Laser resection is often possible and may be the treatment of choice in elderly or inoperable patients. Because of lower risk, laser resection is frequently preferred to conventional operative resection in patients with tracheal hamartomas.

Adult↗
PubMed1989

[Short-term therapy of lung tuberculosis using a fixed combination of isoniazid, rifampicin and pyrazinamide. Results after 2 years].

Treatment of tuberculosis should be as short and as simple as possible in order to improve patient compliance; and combinations of at least three drugs should be used in order to kill the different populations of mycobacteria and to avoid development of drug resistance.--In a controlled multicentre study two regimens were compared in 93 patients with newly-diagnosed pulmonary tuberculosis: 1) Six-month therapy (47 cases): Daily rifampicin and isoniazid, supplemented with pyrazinamide for the first 2 months. A tablet with a fixed combination of 120 mg rifampicin, 50 mg isoniazid and 300 mg pyrazinamide (Rifater) was used. 2) Present Swiss standard therapy (46 cases): Daily rifampicin, isoniazid and ethambutol for 2 months followed by rifampicin and isoniazid for 7 months.--The time-course of culture negativation and the frequency of adverse events were similar in the two groups. During a follow-up period of at least two years only one relapse was observed in the six-month regimen, 3 months after completion of treatment. This was one of three patients with pretreatment resistance to isoniazid. Nevertheless, two of them were cured with the six-month regimen containing Rifater.--Patient compliance, assessed during outpatient treatment by detecting isoniazid metabolites in the urine, was very good (93% of tests were positive in each group).--These results with a follow-up of more than 2 years, indicate that short-course therapy of 6 months duration with the fixed combination tablet may be recommended as treatment of choice in pulmonary tuberculosis except in cases of isoniazid resistance and other special situations (i.e. large cavitations, large number of viable bacilli).

Adult↗
PubMed1988

[Diagnosis and therapy of pleural empyema].

21 patients with thoracic empyema were treated at this clinic over a period of 3 years. 15 patients had metapneumonic empyema, 2 empyema associated with sepsis, and 4 postsurgical empyema. In 12 patients the underlying illness was chronic disease while 9 patients were thus far in good health. The most frequent causative pathogens were staphylococci and streptococci, together with anaerobic bacteria. One patient died of the underlying disease. Three cases of metapneumonic empyema healed completely with antibiotics only. Closed chest tube drainage with small chest tube was performed 13 times and was successful 11 times with a mean drainage duration of 13 days. Six patients underwent surgery (early decortication in 4 instances, late decortication in 2). The surgical indication was in 4 instances multilocular of the empyema which inhibited chest tube drainage, imminent loss of function in 1 case and unsuccessful drainage in a case of bronchopleural fistula in 1 instance. Apart from high-dose antibiotic therapy, earliest possible drainage is of crucial importance in the treatment of thoracic empyema. Surgery should be considered only in uncomplicated empyema if drainage is impossible for technical reasons.

Adult↗
PubMed1988

[Pleural diseases: an unusual cause of cough].

The parietal pleura contains myelinated sensitive nerve fibers as well as mechanoreceptors which coordinate the breathing muscles. The small volume of fluid within the pleural space is in dynamic balance: hydrostatic and colloid-osmotic pressures maintain a constant flow of fluid from the parietal to the visceral pleura, which turns into pleural effusion under pathological conditions. Separation of transudate from exudate is best done by calculation of the protein and LDH ratios in the pleural fluid and in serum. Transudates of cardiac origin are due to congestive left heart failure alone. In detecting subpulmonary pleural effusion, ultrasonography is more accurate than X-ray in lateral decubitus. Pleural exudate is investigated by chemical, microbiological and cytological examination of the fluid, complemented by pleural biopsy, fibre bronchoscopy and thoracoscopy. In this way less than 10% of pleural effusions remain unexplained.

Cough↗
PubMed1987

[The significance of computerized tomography of the chest in the staging of bronchial carcinoma].

The value of thoracic computed tomography in the staging of non-small cell bronchogenic carcinoma is evaluated. In 57 patients post thoracotomy and in 8 patients who had undergone mediastinoscopy, the preoperative T and N stages determined by CT were compared with the intraoperative stage. With respect to the T3 stage, 49 CT results out of a total of 57 were correct, 6 were false positive and 2 false negative. This corresponds to a sensitivity of 67% and a specificity of 88%. With respect to the N2 stage, 55 out of 65 results were correct, 8 were false positive and 2 false negative, corresponding to a sensitivity of 87% and a specificity of 84%. We conclude that in N2-negative CTs mediastinoscopy can be omitted, while in CT-positive patients histological verification appears to be necessary. The diagnosis of T3 should be carried out with caution: in doubtful cases surgical exploration is recommended.

Adult↗
PubMed1987

[Justification of the TNM classification system in lung carcinoma].

The clinical TNM classification system allows improved exchange of information, is an aid in tumor staging and establishing treatment schedules, assists in assessing prognosis and forms the basis of cancer registration. New elements in the last edition of classifications are stage T4, which means a tumor invading the mediastinum, the heart, the great vessels, the trachea, the esophagus, vertebral bodies, the carina or the pleural space, and stage N3, which includes mediastinal, contralateral hilar, scalene and supraclavicular lymph node metastases. Both stages rule out surgical treatment. Mediastinoscopy is advised in the case of lymph nodes in thoracic CAT of greater than or equal to 1.5 cm diameter. There is evidence that most peritumoral infiltrations consist in T lymphocytes, presenting the host's immunological reaction against tumor tissue. In the context of tumor staging such phenomena may be of prognostic significance.

Humans↗
PubMed1986

[Diagnosis and therapy of lung abscess].

10 patients with primary lung abscess have been treated for 2 years. The patients were predominantly middle-aged men with predisposing factors for aspiration such as, essentially, alcoholism. All patients were in a fairly good general condition. The most frequent symptom was purulent foul smelling sputum. Most abscesses were found in the dorsal segments of both lower lobes and of the right upper lobe. Bacteriological examination of abscess punctate frequently revealed anaerobic bacteria. The primary treatment in all cases was conservative, including postural drainage and longterm therapy with high dose penicillin or amoxicillin. In 9 cases this led to complete clinical and radiological recovery; only 1 patient had to be operated on because of failure of conservative therapy. Aspiration of anaerobic bacteria from the oropharynx is of prime importance in the genesis of primary lung abscess. Therapy is conservative, with penicillin as the drug of choice.

Adult↗
PubMed1985

[Bronchoalveolar immunoglobulins in sarcoidosis].

In 9 patients with active and 10 patients with inactive sarcoidosis, and in 6 normal controls, the concentration of IgM, IgA and IgG broncho-alveolar lavage (BAL) fluid was measured. Patients with active sarcoidosis showed significantly higher values of these immunoglobulins than patients with inactive sarcoidosis or normals. In addition, a significant correlation between the immunoglobulin levels and the number of helper-T lymphocytes in the BAL fluid was demonstrated.

Bronchi↗
PubMed1985

T-lymphocyte subsets and immunoglobulin concentrations in bronchoalveolar lavage of patients with sarcoidosis and high and low intensity alveolitis.

Reproducible volumes of bronchoalveolar lavage (BAL) fluid were recovered from 19 patients with pulmonary sarcoidosis and from 6 control subjects using a standardized technique. Studies of cell surface markers showed that BAL from 9 patients contained more than 8 X 10(6) helper T-cells. These patients were classified as having high intensity alveolitis, whereas in 10 patients with lower cell counts, low intensity alveolitis was diagnosed. Activated helper T-cells coexpressing Leu-3a and Ia-antigens were significantly more numerous in BAL from patients with high intensity alveolitis than in BAL from the other patients and the control subjects. Concentrations of IgM, IgA, and IgG, but not of albumin were markedly increased in BAL from patients with high intensity alveolitis when compared with the other subjects. In BAL from both patient and control groups, numbers of helper T-cells and particularly of activated helper T-cells were correlated with immunoglobulin concentrations. In 4 patients with high intensity alveolitis, prednisone-induced and spontaneous clinical improvement were paralleled by a decrease in helper and activated helper T-cells and in immunoglobulin concentrations in BAL, indicating conversion of high to low intensity disease. No change was observed in 4 patients with low intensity alveolitis.

Adult↗
PubMed1984

[Determination of the activity and control of the course of sarcoidosis using bronchoalveolar lavage].

The active stage of sarcoidosis is marked by lymphocyte-rich alveolitis with predominance of helper-T-lymphocytes. 8 patients with sarcoidosis were investigated by bronchoalveolar lavage. Of these patients, 5 proved to have high-intensity and 3 low-intensity alveolitis. It was observed that the total number of helper-T-lymphocytes in the lavage liquid was many times higher than in the patients with low-intensity alveolitis. 4 of the 5 patients with high-intensity alveolitis were treated with prednisone. Parallel to the radiological, functional and clinical improvement, a significant decrease in the absolute number of helper-T-lymphocytes was observed in the lavage liquid, as well as a decrease in the ratio of helper- to suppressor-T-lymphocytes.

Adult↗
PubMed1982

[Use of broncho-alveolar lavage in the diagnosis, activity determination and follow-up of sarcoidosis. Preliminary report].

Pulmonary sarcoidosis is associated with granulomas and alveolitis at certain stages with accumulation of helper T-lymphocytes. The activity of alveolitis was determined by analysis of T-lymphocytes recovered by bronchoalveolar lavage. Only the alveolitis stage of sarcoidosis is influenced by treatment. 3 patients of a total of 5 fulfilled the criteria of active sarcoidosis. The course in 5 cases is discussed.

Adolescent↗
PubMed1980

[Spirometric course control after lung surgery].

72 patients who had undergone pulmonary resection for different causes and of varying degree were followed up by spirometry over a period of two years at 6-month intervals. The patients were allocated to groups according to the preexistent bronchiolar obstruction and extent of lung resection. FEV1 was found not to be essentially altered by surgery. The adaptation of lung function takes at least one year. Ventilatory reserves remain sufficient. The measured spirometric values in pneumonectomized patients two years after operation are 10% above predicted values.

Adult↗
PubMed1979

[Possibilities of respiratory rehabilitation in the hospital].

Among the forms of respiratory insufficiency, those of acute decompensation have the best chance of cure and require all the facilities of clinical and emergency treatment. The therapeutic bases are antibiotics, IPPB, inhalation of broncholytic and secretolytic aerosols, physiotherapy and in some cases steroids. The home care program must be established and practised in the hospital, and its performance controlled and adapted in cooperation between family doctor and lung function laboratory in the clinic.

Albuterol↗