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Biomedical subjects

J Kofler

Publications and source records attributed to J Kofler.

At least 55 records · Page 3Linked to original sources
PubMed1998

[Use of sodium ceftiofur in the combined therapy of complicated septic diseases in cattle].

The use of Sodium-Ceftiofur (Excenel) with a dosage regimen of 1 mg/kg body mass intramuscularly was evaluated in the therapy of complicated claw diseases, like septic arthritis of the distal interphalangeal joint, septic tenosynovitis of the digital flexor tendon sheath or complicated interdigital necrosis. Sodium-Ceftiofur was applied in 34 dairy cattle in addition to surgical intervention. 14 cattle of the control group perceived only surgical intervention without additional antibiotic therapy. Application of the cephalosporin proved to be necessary, with the untreated animals exhibiting far more disturbance of the reconvalescence course in the postoperative phase. Treated animals had a decreasing duration of the postoperative stay at the clinic. Sodium-Ceftiofur was found to be an effective antibiotic in the therapy, an application over a five- to 10-day-period is recommended in complicated digital diseases. As a side effect five cows exhibited slight diarrhea, which disappeared without additional treatment.

Animals↗
PubMed1997

[A protocol for the assessment of patients with coma of unknown origin].

OBJECTIVE: Evaluation of the applicability of a protocol designed for the quick and efficient management of patients with coma of unknown origin (CUO). METHODS: Every patient admitted to our Emergency Department with the diagnosis of CUO was evaluated with our diagnostic protocol. The first diagnostic steps included evaluation of the hemodynamic and respiratory situation, Glasgow Coma Scale, basic neurologic and clinical examination, as well as blood withdrawal, for analysis of metabolic and toxicologic parameters. If indicated, cranial computer tomography (CCT) and/or lumbar puncture were performed. RESULTS: Within the study period from 1. 1. 1995 until 30. 9. 1996, 122 patients (65 males, median age 50 years, 25 and 75 percentile: 33; 69) were included. Blood analysis and the toxicological screening were diagnostic effective in 66 patients, clinical examination and body temperature in one case each, CCT in 50 patients and lumbar puncture in 2 patients. By the use of this diagnostic protocol 51 neurologic, 38 toxicologic, 28 metabolic and 2 infectious causes of coma were diagnosed (98%). Etiology of 2 of the comas remained unclear. CONCLUSION: By using our protocol, 98% of the causes of CUO were clarified. The main causes of coma were of neurological, toxicological and metabolic origin. CCT and the blood analysis were the most important procedures leading to a final diagnosis.

Adult↗
PubMed1997

Renal tolerability of four different once-daily dose regimen of netilmicin in critical care patients.

A prospective, randomized trial was conducted in a medical intensive care unit to assess safety and tolerability of four different dose regimens of intravenous netilmicin given once daily in the treatment of febrile episodes in critically ill patients. Eighty patients with febrile episodes during their stay in the intensive care unit were included in the study. The patients were randomized into four groups: Group 1 received a single daily dose of netilmicin based upon weight, age and renal function according to a dosage nomogram [13] (mean dose 298 +/- 29 mg, median 300 mg, range 250-350 mg), group 2 received 150% of this standard dose (mean 418 +/- 45 mg, median 400 mg, range 350-500 mg), group 3 200% (mean 525 +/- 41 mg, median 500 mg, range 400-550 mg) and group 4 250% (mean 710 +/- 39 mg, median 650 mg, range 600-750 mg). Duration of treatment was six days. Positive cultures were obtained in 29 patients. Serum creatinine and creatinine clearance, as well as netilmicin trough levels and levels of alpha 1-microglobulin showed no significant difference between the groups before, during, and after therapy. Our results indicate that with once daily dosing even high doses of netilmicin are well tolerated in patients with a creatinine clearance of > 70 ml/min before therapy. Necessary precautions include monitoring of drug trough levels (< 1 mg/L) and maintenance of adequate volume status.

Acute Kidney Injury↗
PubMed1997

Long-term ultrasonographic and venographic study of the development of tarsal vein thrombosis in a cow.

The development of thrombosis of three tarsal veins in a cow was studied by repeated ultrasonographic and venographic examinations for nine months. The venous diameter, the echogenicity of the thrombi and the sequential venographic findings were evaluated. Initially, the thrombosed parts of the ramus cranialis and caudalis of the vena saphena lateralis and the ramus caudalis of the vena saphena medialis had greatly increased diameters and were not compressible. The thrombi appeared as poorly echogenic masses. Within five months, the diameters of the occluded veins had decreased to almost normal dimensions. The echogenicity of the thrombi diminished at their distal and proximal ends. The length of the thrombi was decreased by up to 6.5 cm. However, the thrombosed veins did not re-open. One year after diagnosis, the cow was culled and the persistence of the venous thromboses was confirmed.

Animals↗
PubMed1996

Ultrasonographic imaging of pathology of the digital flexor tendon sheath in cattle.

The clinical, radiographic, ultrasonographic and exploratory centesis findings in 33 cattle suffering from a septic tenosynovitis of the digital flexor tendon sheath are described. Forty-one digital flexor tendon sheaths were affected: 13 of the cattle had a unilateral and eight had a bilateral septic tenosynovitis, and in the other 12 cattle with unilateral tenosynovitis one or more of the digital joints were also involved. The distended compartments of the digital flexor tendon sheath and the affected digital joint recesses could be determined accurately by ultrasonography. Depending on the type of inflammation (serous, fibrinous or purulent) the compartments and recesses were filled with anechoic, heterogeneous hypoechoic or echogenic inflammatory content. Flow-phenomena could be observed when there were effusions of liquid into the synovial cavities. Ultrasonography provided accurate preoperative details of the pathological changes to the affected tendon sheaths and the adjoining digital joints. The characteristic ultrasonographic features of septic tenosynovitis of the digital flexor tendon sheath are described.

Animals↗
PubMed1996

Application of real-time ultrasonography for the detection of tarsal vein thrombosis in cattle.

The clinical and ultrasonographic features of the thrombosis of three tarsal veins in a six-year-old dairy cow are described. Thrombosis and metastatic abscessation developed on the left tarsus six days after the amputation of the lateral claw of the left hindlimb. Originally, the cow suffered from a severe purulent arthritis of the distal interphalangeal joint and a retroarticular abscess, caused by interdigital necrobacillosis. By means of real-time ultrasonography, using a 7.5 MHz transducer, a marked subcutaneous oedema, a subcutaneous abscess, and a thrombosis of the ramus cranialis and ramus caudalis of the vena saphena lateralis reaching the confluence into the vena saphena lateralis and a thrombosis of the ramus caudalis of the vena saphena medialis could be identified. The thrombosed veins were not compressible, were oval and had an increased diameter of up to 9 x 12 mm. Intraluminal masses were visualised as hypoechoic structures and the veins distal to the thrombosis were distended up to 10 x 13 mm. The differential diagnosis and pathogenesis of the thrombosis and the abscessation are discussed, and the clinical course and the sonographic observations of the thrombosis during a six week period are described.

Abscess↗
PubMed1996

Arthrosonography--the use of diagnostic ultrasound in septic and traumatic arthritis in cattle--a retrospective study of 25 patients.

The case records, clinical, radiographic, ultrasonographic and arthrocentesis findings from 25 cattle with septic or traumatic arthritis were reviewed. The total of 30 joints involved were: articulatio cubiti (elbow joint)-1, articulatio carpi (carpal joint)-10; articulatio genus (stifle joint)-4, articulatio tarsocruralis (tarsocrural joint)-8; articulatio metacarpo-/metatarsophalangea (metacarpo-/metatarsophalangeal joint -7. Ultrasonographic investigation was performed using 7.5 MHz linear and 5 MHz sector transducers. In eight cattle, a concurrent infection of periarticular tendon sheaths or hygroma was diagnosed. The distension of the joint cavities could be imaged in all cases. Assessing echogenicity, acoustic enhancement, ultrasonographic character of the exudate (liquid or clotted) and findings revealed by aspiration, arthrotomy or at necropsy, the synovial effusion was classified as: serous, fibrinous or fibrino-purulent. Diagnostic ultrasound provided a comprehensive preoperative diagnosis in septic and traumatic arthritis by imaging the accurate localization of soft-tissue swelling and the extent and consistency of joint effusion.

Animals↗
PubMed1996

[Results of critical care management of patients after bone marrow transplantation].

In a retrospective study we investigated the clinical course of patients who required intensive care support after bone marrow transplantation. Out of 25 patients only 5 (20%) survived treatment in the intensive care unit (ICU) and this group showed a significantly lower age, lower APACHE III and organ-failure scores and higher serum albumin values, as well as a longer interval between bone marrow transplantation and admission to intensive care. However, no patient requiring mechanical ventilation primarily for pneumonia or other infections arising as a complication of bone marrow transplantation survived intensive care. All patients requiring ventilation for more than 24 hours died in hospital. Of the 5 patients surviving ICU treatment only 3 were eventually discharged from hospital and only one single patient was alive after 6 months. Hence, current intensive care management appears to be indicated in only a small group of patients after bone marrow transplantation.

APACHE↗
PubMed1995

Angular limb deformity in a calf treated by periosteotomy and wedge osteotomy.

A carpus valgus deformity was diagnosed in a five-week-old Brown Swiss calf. The 45 degrees deformity was caused by the malaligned healing of a fracture of the left metacarpus after birth trauma. The deviation improved to 25 degrees after being treated with a semicircular lateral periosteotomy above the distal physis of the radius. A complete correction was made by means of a wedge osteotomy five months after the first treatment. A 20 degrees wedge of bone was removed. The metacarpus was stabilised with a seven-hole dynamic compression plate which was removed 12 weeks later. Thirty months later the calf was sold as a pregnant heifer at an auction of breeding cattle.

Animals↗
PubMed1995

[Description and determination of the diameter of arteries and veins in the hindlimb of cattle using B-mode ultrasonography].

The large arteries and veins of both metatarsal and digital regions of 14 healthy, non-pregnant cows with a mean age of 6.1 +/- 1.7 years were examined sonographically (real-time B-mode system with a 7.5 MHz linear-transducer). The ultrasonographic imaging of the larger vessels was investigated, diameters were measured, especially of the digital veins, in which intravenous regional anaesthesia and antibiosis is usually applied. Three measurements per cow on each distal hindlimb were noted over a period of 3 weeks using defined anatomical locations. The mean diameter of the vessels were as follows: Arteria (A.) dorsalis pedis 4.1 +/- 0.4 mm, Vena (V.) dorsalis pedis 5.2 +/- 0.5 mm, A. metatarsea dorsalis III 3.3 +/- 0.4 mm, A. digitalis dorsalis communis III 3.9 +/- 0.4 mm, V. digitalis dorsalis communis III 2.7 +/- 0.4 mm, V. digitalis plantaris communis IV 2.1 +/- 0.4 mm, V. digitalis plantaris communis II 2.1 +/- 0.3 mm, V. metatarsea plantaris lateralis 4.5 +/- 0.8 mm, V. metatarsea plantaris medialis 4.4 +/- 0.6 mm. The Ramus cranialis of the V. saphena lateralis, the A. and V. digitalis plantaris communis III and the A. digitalis plantaris communis II and IV could only be imaged in a few cases. Except for V. digitalis dorsalis communis III, statistical analysis of the mean diameters of the examined vessels of the right and the left distal hindlimb in 14 cows revealed no significant differences (P < 0.05). B-mode ultrasonography proved a suitable method for imaging and examination of the vessels larger than 1 mm in the distal bovine hindlimb and can be recommended as the non-invasive method of choice for the examination of blood vessels in cattle.

Animals↗
PubMed1995

[Septic arthritis of the pastern in cattle--clinical, radiological and sonographic findings and treatment].

Clinical, radiographic, sonographic, arthrocentesis and intraoperative findings in 19 cattle suffering from a septic arthritis of the proximal interphalangeal (p.i.p.) joint in 20 digits were evaluated retrospectively. In 6 cattle the p.i.p. joint was exclusively affected, in 13 animals a concurrent infection was ascertained in other 18 synovial cavities: digital flexor tendon sheath and the adjoining digital joints. As origin of the p.i.p. joint infection 11 cases showed perforating wounds, 6 cases a contiguous spread from adjacent purulent tissue affections and in 2 calves a haematogenous contamination was found. According to the progress of septic joint affection the increasing severity of the radiographic findings in this study were classified in 6 degrees. This systematic classification of the radiographic findings of septic arthritis in cattle is proposed as a basis for a comparable description and diagnosis of the radiographic signs. The sonographic imaging of the distended dorsal and plantar recesses of the p.i.p. joint in 3 cattle was proved to be a valuable adjunct to the other examination methods available. Five animals were slaughtered after diagnosis. An amputation through the distal third of the phalanx proximalis, respectively a modified disarticulation in the p.i.p. joint was performed in 14 patients. After an average hospitalization of 4.6 weeks the 13 healed patients were dismissed.

Animals↗
PubMed1995

[The use of ultrasonic examination for the diagnosis of diseases of the locomotor system in cattle].

Besides the classical orthopedic examination, radiography and centesis of diseased synovial cavities ultrasonography was applied, for the first time, in 18 cattle for the investigation of proximal bovine limb disorders. The clinical and radiographic findings as well as the results of centesis were compared with the sonographic findings. Arthritis, tenosynovitis, bursitis, abscess formation and haematomas especially in proximal limb regions were observed. A 7,5 MHz linear-scan or a 5 MHz sector-scan were used for ultrasonic examination. By means of radiography, 8 out of 14 cattle showed a soft tissue swelling, whereas specific radiographic findings could only be determined in those cases with affection of joints and bones. The sonographic examination produced more information than radiography when only soft tissues and joints were affected. As a complimentary tool to the classical examination of locomotory system disorders in cattle, sonography provided accurate preoperative details of the extent and character of fluid accumulations and soft tissue swellings. It helped to differentiate rapidly and on a non-invasive basis between affected structures and any subtle defects in neighbouring tissues, it enabled a more accurate centesis of evident fluid filled areas of synovial cavities or other swellings, and revealed much more information than often insufficiently depicted on radiographs. Sonography was, therefore, the imaging method of choice to differentiate pathologic involvement of soft tissue structures in bovine limbs.

Abscess↗
PubMed1994

[New possibilities for the diagnosis of septic tenosynovitis of the digital flexor tendon sheath in cattle using sonography--therapy and long-term results].

Sonographic examination is a new and very effective method in diagnosing of septic tenosynovitis in cattle and may be regarded as an valuable help to the classic diagnostic methods. Among 563 patients, 22 animals suffered exclusively from a serofibrinous, purulent or necrotising tenosynovitis of the digital flexor tendon sheath. In 11 cases, a resection of both flexor tendons, in 2 cases a resection of the deep flexor tendon only were performed, and in 4 cases the tendon sheath was surgically opened and irrigated. 5 animals were slaughtered after diagnosing, because both tendon sheaths of the same limb suffered from a purulent or necrotising tenosynovitis. Surgery was performed using intravenous regional anesthesia and antibiosis. Clinical, radiographic, sonographic and centesis findings are presented. Sonography enabled an accurate assessment of the extent of the inflammation and an assessment of eventual adhesions. It was therefore possible to obtain a comprehensive preoperative image about the condition of the diseased tendon sheath. Intraoperative findings are compared with sonographic diagnosis. After an average hospitalisation of 26.5 days, the patients returned to their owners. Postoperative long term follow-up from 8 months to a maximum of 8 years was evaluated in 17 animals. The minimum duration of economic use of all animals averaged 29.2 months with a range of 1 to 69 months. At the time of survey 9 cows (52.9%) were still alive. 15 cows (88.2%) produced a total of 34 calves with a maximum of 6 calves in one cow. Details on the status of the operated limb, the postoperative milk yield and reasons for culling are discussed.

Animals↗
PubMed1993

[Cauda equina syndrome in a Fleckvieh bull after a pathological fracture of the first sacral vertebra caused by a spindle cell sarcoma].

A 9 month old Simmental fattening bull was presented with signs of a cauda equina syndrome. An epidurographic examination was made after thorough clinical, neurological and routine radiographic examination. The cause of the cauda equina compression--a spindle cell sarcoma--was revealed by the pathologic-histologic examination. This tumor caused the compression of the cauda equina and pathologic transverse fracture of the body of the first sacral vertebra and cranial epiphyseal fracture of the 1st and the 3rd sacral vertebra as well as the separation of the arcus from the first and second sacral vertebral bodies. Some other diseases which can cause cauda equina syndrome are mentioned.

Animals↗
PubMed1990

[Acute tonsillitis: clinical symptoms; bacteriologic culture and rapid test as deciding criteria for the use of antibiotics].

In order to prevent late sequelae from an untreated streptococcal pharyngitis all patients with streptococcal tonsillitis/pharyngitis have to be treated with antibiotics, preferably penicillin. A correct diagnosis by clinical criteria is only achievable in 72% of patients with streptococcal pharyngitis. Additional criteria such as diagnosis by culture are, therefore, mandatory. Time is a major disadvantage of traditional culture methods. Slide agglutination tests show an acceptable sensitivity of 92% and a specificity of 93%. Due to the possibility of false negative test results, with consequent withholding of adequate antimicrobial chemotherapy, these test results should be used only as a valuable guide. Decision to administer an antibiotic should still be based on clinical criteria.

Adolescent↗
PubMed1990

[Laminitis with a high degree of osteitis rarefaciens of the distal phalanx in a Fleckvieh bull].

Chronic laminitis with severe rarefactive osteitis was diagnosed in a nine month old Simmental fattening bull. The condition was observed in all eight weight bearing digits. Clinical, radiological and pathomorphological examinations revealed osteolysis and downward rotation of all the distal phalanges. The condition appears to resemble the several cases of laminitis in Jersey cattle, which have been attributed to hereditary factors. In this case, however, the genetic background was unavailable for evaluation.

Animals↗
PubMed1986

[Studies of the penetrating ability of fosfomycin into the aqueous humor and vitreous body of the eye].

Fosfomycin is an antibiotic with a new simple chemical structure and a broad spectrum of antibacterial activity, especially against staphylococci. In the study reported here, the penetration of fosfomycin into the aqueous humor and vitreous body was investigated after intravenous infusion of 4 and 8 g. The highest average concentration approximately 2 hours after administration was 28.3 micrograms/ml after the 4 g dose and 52 micrograms/ml after the 8 g dose. Both the 4 g and 8 g doses thus produced aqueous humor levels exceeding the minimum inhibitory concentrations required for most gram-positive and gram-negative organisms commonly responsible for bacterial endophthalmitis, including strains of pseudomonas aeruginosa. Extremely high aqueous humor levels of fosfomycin were observed in two patients with inflamed eyes because of a change in the blood-aqueous barrier.

Aqueous Humor↗